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使用两种妊娠期糖尿病诊断标准(卡彭特-库斯坦标准和国际糖尿病与妊娠研究组(IADPSG)标准)对妊娠结局的比较

A Comparison of Pregnancy Outcomes Using Two Diagnostic Criteria for Gestational Diabetes Mellitus-Carpenter Coustan Criteria and International Association of the Diabetes and Pregnancy Study Groups (IADPSG) Criteria.

作者信息

Tahmina Sultana, Daniel Mary

机构信息

Department of Obstetrics and Gynaecology, Pondicherry Institute of Medical Sciences, Pondicherry, India.

出版信息

J ASEAN Fed Endocr Soc. 2017;32(1):27-31. doi: 10.15605/jafes.032.01.05. Epub 2017 Apr 12.

Abstract

OBJECTIVE

To compare the maternal and perinatal outcomes in women with GDM diagnosed by Carpenter & Coustan (CC) criteria and by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria.

METHODOLOGY

A cross-sectional comparative study was conducted using data of women who were screened and diagnosed with GDM between April 2006-March 2007 using the CC criteria and April 2013-March 2014 using IADPSG criteria. Maternal and perinatal outcomes were noted. Means and proportions were calculated for continuous and categorical variables respectively. Data were analyzed using t-test for normally distributed data and Mann-Whitney U test for those that were not normally distributed. Pearson Chi-square test was used to find an association between the various outcomes between the two groups.

RESULTS

Among 500 pregnant women screened, 36 were diagnosed GDM in the CC group. In the IADPSG group, 733 women were screened and 167 were diagnosed GDM. Prevalence of GDM was 7.2% in CC group and 22.78% in IADPSG group (p=0.000). There was a statistically significant difference in the number of women who developed hypertension and polyhydramnios among the two groups. Women who had an operative vaginal delivery (16.67% vs. 6.6%, p=0.085) and mean birth weight (3.10 ± 0.55 kg vs. 2.97 ± 0.48 kg, p=0.165) were higher in CC group than the IADPSG group. Among the perinatal outcomes, a statistically significant improvement was found in the number of neonates developing respiratory distress syndrome (p=0.000) and hyperbilirubinemia (p=0.000), when the IADPSG criteria were used.

CONCLUSIONS

There is a statistically significant difference between the maternal and neonatal outcomes when the newer IADPSG criteria were used for diagnosis of GDM.

摘要

目的

比较采用卡彭特与库斯坦(CC)标准和国际糖尿病与妊娠研究组协会(IADPSG)标准诊断的妊娠期糖尿病(GDM)女性的孕产妇及围产期结局。

方法

开展一项横断面比较研究,使用2006年4月至2007年3月采用CC标准以及2013年4月至2014年3月采用IADPSG标准进行筛查和诊断为GDM的女性的数据。记录孕产妇及围产期结局。分别计算连续变量和分类变量的均值及比例。对正态分布数据采用t检验,对非正态分布数据采用曼-惠特尼U检验进行数据分析。采用Pearson卡方检验来发现两组之间各种结局的关联。

结果

在筛查的500名孕妇中,CC组有36例被诊断为GDM。在IADPSG组,筛查了733名女性,其中167例被诊断为GDM。CC组GDM患病率为7.2%,IADPSG组为22.78%(p = 0.000)。两组中发生高血压和羊水过多的女性数量存在统计学显著差异。CC组接受阴道助产的女性比例(16.67%对6.6%,p = 0.085)和平均出生体重(3.10±0.55千克对2.97±0.48千克,p = 0.165)高于IADPSG组。在围产期结局方面,采用IADPSG标准时,新生儿发生呼吸窘迫综合征(p = 0.000)和高胆红素血症(p = 0.000)的数量有统计学显著改善。

结论

采用更新的IADPSG标准诊断GDM时,孕产妇和新生儿结局存在统计学显著差异。

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本文引用的文献

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Evaluation of the International Association of the Diabetes In Pregnancy Study Group new criteria: gestational diabetes project.
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