Department of Epidemiology, Brown University School of Public Health.
Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Clin Obstet Gynecol. 2021 Mar 1;64(1):234-243. doi: 10.1097/GRF.0000000000000585.
Gestational diabetes mellitus (GDM) complicates 6% to 8% of pregnancies and up to 50% of women with GDM progress to type 2 diabetes mellitus (DM) within 5 years postpartum. Clinicians have little guidance on which women are most at risk for DM progression or when evidence-based prevention strategies should be implemented in a woman's lifecycle. To help address this gap, the authors review identifiable determinants of progression from GDM to DM across the perinatal period, considering prepregnancy, pregnancy, and postpartum periods. The authors categorize evidence by pathways of risk including genetic, metabolic, and behavioral factors that influence progression to DM among women with GDM.
妊娠期糖尿病(GDM)会使 6%至 8%的妊娠复杂化,多达 50%的 GDM 妇女在产后 5 年内会进展为 2 型糖尿病(DM)。临床医生对于哪些女性最有可能进展为 DM 或何时在女性的生命周期中实施基于证据的预防策略方面几乎没有指导。为了帮助解决这一差距,作者回顾了整个围产期从 GDM 进展为 DM 的可识别决定因素,考虑了孕前、孕期和产后时期。作者通过影响 GDM 妇女发生 DM 的风险途径(包括遗传、代谢和行为因素)对证据进行分类。