Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, SE 70182 Örebro, Sweden.
Department of Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, SE 70 182 Örebro, Sweden.
Diabetes Res Clin Pract. 2021 Feb;172:108642. doi: 10.1016/j.diabres.2020.108642. Epub 2021 Jan 13.
Quantify the proportional increase in gestational diabetes (GDM) prevalence when implementing the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria compared to prior GDM criteria, and to assess risk factors that might affect the change in prevalence.
A systematic review and meta-analysis was performed of cohort and cross-sectional studies between January 1, 2010 to December 31, 2018 among pregnant women with GDM using IADPSG criteria compared to, and stratified by, old GDM criteria. Web of science, PubMed, EMBASE, Cochrane, Open Grey and Grey literature reports were included. The relative risk for each study was calculated. Subgroup analyses were performed by maternal age, body mass index, study design, country of publication, screening method, sampling method and data stratified according to diagnostic criteria.
Thirty-one cohort and cross-sectional studies with 136 705 women were included. Implementing the IADPSG criteria was associated with a 75% (RR 1.75, 95% CI 1.53-2.01) increase in number of women with GDM with evidence of heterogeneity.
The IADPSG criteria increase the prevalence of GDM, but allow movement towards more homogeneity. More studies are needed of the benefits, harms, psychological effects and health costs of implementing the IADPSG criteria.
定量比较采用新的国际糖尿病与妊娠研究组（IADPSG）标准与既往妊娠糖尿病标准时，妊娠糖尿病（GDM）患病率的比例增加，并评估可能影响患病率变化的危险因素。
对 2010 年 1 月 1 日至 2018 年 12 月 31 日期间采用 IADPSG 标准诊断 GDM 的队列研究和横断面研究进行了系统评价和荟萃分析，并按旧的 GDM 标准进行分层。检索了 Web of science、PubMed、EMBASE、Cochrane、Open Grey 和灰色文献报告。计算了每项研究的相对风险。按母亲年龄、体重指数、研究设计、出版国家、筛查方法、抽样方法和根据诊断标准分层的数据进行了亚组分析。
共纳入 31 项队列研究和横断面研究，共 136705 名女性。采用 IADPSG 标准与 GDM 女性人数增加 75%（RR 1.75，95%CI 1.53-2.01）相关，存在异质性。
IADPSG 标准增加了 GDM 的患病率，但可使诊断标准更趋一致。需要更多的研究来评估采用 IADPSG 标准的益处、危害、心理影响和健康成本。
