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COVID-19 大流行导致妊娠期糖尿病诊断标准改变后的临床结局:病例对照研究。

Clinical Outcomes Following a Change in Gestational Diabetes Mellitus Diagnostic Criteria Due to the COVID-19 Pandemic: A Case-Control Study.

机构信息

UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, 4 Dublin, Ireland.

UCD School of Medicine, 4 Dublin, Ireland.

出版信息

Int J Environ Res Public Health. 2022 Feb 8;19(3):1884. doi: 10.3390/ijerph19031884.

DOI:10.3390/ijerph19031884
PMID:35162907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8835277/
Abstract

BACKGROUND

Due to COVID-19, many centres adopted a change to the diagnosis of GDM.

METHODS

A case-control study of antenatal patients between 1 April and 30 June in 2019 and 2020 looking at detection rates of GDM, use of medication, obstetric, and fetal outcomes.

RESULTS

During COVID-19, the rate of positive GDM tests approximately halved (20% (42/210) in 2020 vs. 42.2% (92/218) in 2019, ( < 0.01)) with higher rates of requirement for insulin at diagnosis (21.4% (2020) vs. 2.2% (2019); < 0.01), and at term (31% (2020) vs. 5.4% (2019); < 0.01). and metformin at diagnosis (4.8% (2020) vs. 1.1% (2019); < 0.01), and at term (14.3% (2020) vs. 7.6% (2019) < 0.01), with no differences in birth outcomes.

CONCLUSIONS

There was likely an underdiagnosis of GDM while women at a higher risk of hyperglycaemia were correctly identified. The GTT should be maintained as the gold-standard test where possible, with provisions made for social distancing during testing if required.

摘要

背景

由于 COVID-19,许多中心改变了 GDM 的诊断方法。

方法

对 2019 年 4 月 1 日至 6 月 30 日期间和 2020 年期间的产前患者进行病例对照研究,观察 GDM 的检出率、药物使用、产科和胎儿结局。

结果

在 COVID-19 期间,阳性 GDM 检测率约减半(2020 年为 20%(42/210),2019 年为 42.2%(92/218),<0.01),诊断时胰岛素需求更高(2020 年为 21.4%(2020 年),2019 年为 2.2%(2019 年);<0.01),和在足月时(31%(2020 年),2019 年为 5.4%(2019 年);<0.01),二甲双胍诊断时(4.8%(2020 年),2019 年为 1.1%(2019 年);<0.01),和在足月时(14.3%(2020 年),2019 年为 7.6%(2019 年);<0.01),出生结局无差异。

结论

GDM 的诊断可能不足,但对高血糖风险较高的妇女进行了正确识别。如果需要,应保持 GTT 作为金标准测试,并在测试期间提供社交距离的规定。

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PLoS One. 2020 Dec 3;15(12):e0243192. doi: 10.1371/journal.pone.0243192. eCollection 2020.
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Impact of changes to national UK Guidance on testing for gestational diabetes screening during a pandemic: a single-centre observational study.英国全国指导意见变更对大流行期间妊娠期糖尿病筛查检测的影响:单中心观察性研究。
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