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葡萄糖筛查试验阳性与巨大儿的关系:一项回顾性队列研究。

Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study.

机构信息

Obstetrics and Gynecology, Kofu National Hospital, Kofu, Japan

Obstetrics and Gynecology, Kofu National Hospital, Kofu, Japan.

出版信息

BMJ Open. 2020 Feb 25;10(2):e034627. doi: 10.1136/bmjopen-2019-034627.

Abstract

OBJECTIVES

There is no consensus regarding a possible relation between false positive glucose challenge test (GCT) results and large-for-gestational-age (LGA) infants. This study aimed to clarify the association between false positive GCT results and LGA, after adjusting for potential confounding factors, using a large clinical dataset.

DESIGN

Retrospective cohort study.

SETTING

National Hospital Organisation Kofu National Hospital, which is a community hospital, between January 2012 and August 2019.

PARTICIPANTS

Japanese women who underwent GCT between 24 and 28 weeks of gestation at the hospital were included. After excluding those with gestational diabetes mellitus, diabetes in pregnancy and multiple pregnancies, subjects were divided into a false positive GCT group (≥140 mg/dL) and a GCT negative group (<140 mg/dL).

METHODS

Obstetric records of patients were examined. The χ-test and multivariable logistic regression analysis were used to investigate the association between false positive GCT results and LGA.

PRIMARY AND SECONDARY OUTCOME MEASURES

Incidence of LGA and the association between false positive GCT results and LGA.

RESULTS

The mean subject age was 31.4±5.5 years, with 43.3% nulliparity (n=974) and 2160 (96.1%) term deliveries. The incidence of LGA was 9.4% (211/2248) and 11.4% (257/2248) of the women had false positive GCT results. False positive GCT results were significantly associated with an increased risk of LGA (OR, 1.51; 95% CI, 1.02 to 2.23), after controlling for maternal age, prepregnancy maternal weight, maternal weight gain during pregnancy and parity.

CONCLUSIONS

It appears that there is a significant association between false positive GCT results and LGA. Additional research is required to confirm these results and to investigate appropriate interventions for women with abnormal screens for gestational diabetes mellitus.

摘要

目的

目前对于糖筛查试验(GCT)假阳性结果与巨大儿(LGA)之间是否存在关联尚无定论。本研究旨在使用大型临床数据集,在调整潜在混杂因素后,明确 GCT 假阳性结果与 LGA 之间的关系。

设计

回顾性队列研究。

地点

国立医院组织甲府国立医院,这是一家社区医院,研究时间为 2012 年 1 月至 2019 年 8 月。

参与者

纳入在该医院 24 至 28 孕周进行 GCT 的日本女性。排除患有妊娠期糖尿病、妊娠合并糖尿病和多胎妊娠的患者后,将受试者分为 GCT 假阳性组(≥140mg/dL)和 GCT 阴性组(<140mg/dL)。

方法

检查患者的产科记录。采用卡方检验和多变量逻辑回归分析,探讨 GCT 假阳性结果与 LGA 之间的关系。

主要和次要结局指标

LGA 的发生率和 GCT 假阳性结果与 LGA 之间的关系。

结果

受试者的平均年龄为 31.4±5.5 岁,初产妇占 43.3%(n=974),2160 例(96.1%)为足月分娩。LGA 的发生率为 9.4%(211/2248),9.4%(211/2248)的女性 GCT 假阳性。校正母亲年龄、孕前体重、孕期体重增加和产次后,GCT 假阳性结果与 LGA 风险增加显著相关(OR,1.51;95%CI,1.02 至 2.23)。

结论

GCT 假阳性结果与 LGA 之间似乎存在显著关联。需要进一步的研究来证实这些结果,并研究针对妊娠期糖尿病筛查异常的女性的适当干预措施。

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