用于诊断早发型妊娠期糖尿病或葡萄糖耐量异常的 NDDG 标准与 IADPSG 或 ADA 标准的比较。

The NDDG criteria versus the IADPSG or the ADA criteria for diagnosing early-onset gestational diabetes mellitus or abnormal glucose tolerance.

机构信息

Department of Obstetrics and Gynecology, University of La Laguna, Tenerife, Canary Islands, Spain.

Spanish Diabetes and Pregnancy Study Group. Sociedad Española de Ginecología y Obstetricia (SEGO) and Sociedad Española de Diabetes (SED, Madrid, Spain.

出版信息

Int J Gynaecol Obstet. 2023 Mar;160(3):906-914. doi: 10.1002/ijgo.14453. Epub 2022 Sep 26.

DOI:10.1002/ijgo.14453

PMID:36087278

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10087419/

Abstract

OBJECTIVE

To analyze the effects of substituting the National Diabetes Data Group (NDDG) criteria with the International Association of Diabetes and Pregnancy Study Groups (IADPSG) or American Diabetes Association (ADA) criteria for the diagnosis of early-onset gestational diabetes mellitus (Early-GDM) or first trimester abnormal glucose tolerance (1 t-AGT).

METHODS

A retrospective cohort study was conducted of 3200 women: 400 with Early-GDM, 800 with GDM, and 2000 with Non-GDM, according to the NDDG criteria. Rates of women with missed and new Early-GDM according to the IADPSG or ADA criteria were calculated. Multivariate logistic regression analysis was used to compare perinatal outcomes between groups.

RESULTS

Using the IADPSG criteria, 61.6% of women with Early-GDM according to the NDDG were undiagnosed (Missed-Early-GDM group), and 25.9% of women with GDM and 15.7% of women with Non-GDM were diagnosed with Early-GDM (New-Early-GDM groups). Perinatal outcomes were worse in Missed-Early-GDM than in Non-GDM and better in New-Early-GDM groups than in the Early-GDM group. According to the ADA recommendations, only 11.8% of women with Early-GDM according to the NDDG criteria were diagnosed.

CONCLUSION

Replacing the NDDG recommendations for the diagnosis of Early-GDM with the IADPSG or ADA criteria would mean depriving a large number of women with AGT and higher risk of adverse perinatal outcomes from early treatment and treating others with lower risk.

摘要

目的

分析以国际妊娠合并糖尿病研究组（IADPSG）或美国糖尿病协会（ADA）标准替代国家糖尿病数据组（NDDG）标准诊断早发妊娠期糖尿病（Early-GDM）或孕早期异常葡萄糖耐量（1t-AGT）的效果。

方法

对 3200 名女性进行回顾性队列研究：根据 NDDG 标准，400 名女性患有 Early-GDM，800 名女性患有 GDM，2000 名女性患有 Non-GDM。计算根据 IADPSG 或 ADA 标准患有漏诊和新发 Early-GDM 的女性比例。采用多变量逻辑回归分析比较各组围产期结局。

结果

使用 IADPSG 标准，根据 NDDG 诊断的 61.6% Early-GDM 女性未被诊断（漏诊 Early-GDM 组），25.9% GDM 女性和 15.7% Non-GDM 女性被诊断为 Early-GDM（新发 Early-GDM 组）。漏诊 Early-GDM 组的围产期结局较 Non-GDM 组差，新发 Early-GDM 组较 Early-GDM 组好。根据 ADA 建议，仅有 11.8% 根据 NDDG 标准诊断的 Early-GDM 女性被诊断。