Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Diabetes Metab J. 2020 Oct;44(5):726-736. doi: 10.4093/dmj.2019.0126. Epub 2020 Apr 13.
The definition of the high-risk group for gestational diabetes mellitus (GDM) defined by the American College of Obstetricians and Gynecologists was changed from the criteria composed of five historic/demographic factors (old criteria) to the criteria consisting of 11 factors (new criteria) in 2017. To compare the predictive performances between these two sets of criteria.
This is a secondary analysis of a large prospective cohort study of non-diabetic Korean women with singleton pregnancies designed to examine the risk of GDM in women with nonalcoholic fatty liver disease. Maternal fasting blood was taken at 10 to 14 weeks of gestation and measured for glucose and lipid parameters. GDM was diagnosed by the two-step approach.
Among 820 women, 42 (5.1%) were diagnosed with GDM. Using the old criteria, 29.8% (n=244) of women would have been identified as high risk versus 16.0% (n=131) using the new criteria. Of the 42 women who developed GDM, 45.2% (n=19) would have been mislabeled as not high risk by the old criteria versus 50.0% (n=21) using the new criteria (1-sensitivity, 45.2% vs. 50.0%, P>0.05). Among the 778 patients who did not develop GDM, 28.4% (n=221) would have been identified as high risk using the old criteria versus 14.1% (n=110) using the new criteria (1-specificity, 28.4% vs. 14.1%, P<0.001).
Compared with the old criteria, use of the new criteria would have decreased the number of patients identified as high risk and thus requiring early GDM screening by half (from 244 [29.8%] to 131 [16.0%]).
美国妇产科医师学会于 2017 年将用于定义妊娠糖尿病高危人群的标准由包含 5 项历史/人口统计学因素的标准（旧标准）改为包含 11 项因素的标准（新标准）。本研究旨在比较这两种标准的预测性能。
这是一项针对韩国单胎妊娠非糖尿病女性的大型前瞻性队列研究的二次分析，旨在研究非酒精性脂肪性肝病女性发生妊娠糖尿病的风险。在妊娠 10-14 周时采集孕妇空腹血样，检测血糖和血脂参数。采用两步法诊断妊娠糖尿病。
在 820 名女性中，有 42 名（5.1%）被诊断为妊娠糖尿病。使用旧标准，29.8%（n=244）的女性将被视为高危人群，而使用新标准，16.0%（n=131）的女性将被视为高危人群。在 42 名发生妊娠糖尿病的女性中，45.2%（n=19）将被旧标准错误地归类为非高危人群，而使用新标准，50.0%（n=21）将被错误地归类为非高危人群（1 敏感性，45.2%比 50.0%，P>0.05）。在未发生妊娠糖尿病的 778 名女性中，28.4%（n=221）将被旧标准归类为高危人群，而使用新标准，14.1%（n=110）将被归类为高危人群（1 特异性，28.4%比 14.1%，P<0.001）。
与旧标准相比，新标准将需要进行早期妊娠糖尿病筛查的高危人群数量减少了一半（从 244 例[29.8%]降至 131 例[16.0%]）。
