2019年冠状病毒病疫情期间妊娠糖尿病新诊断途径的影响
Impact of new diagnostic pathway for gestational diabetes in time of COVID-19.
作者信息
Walker Betrice, Edey Jenna, Hall Leanne, Braniff Kathleen, Heal Clare
机构信息
, Birtinya, AustraliaSunshine Coast University Hospital.
, AustraliaRoyal Brisbane and Women's Hospital Herston.
出版信息
Obstet Med. 2023 Jun;16(2):104-108. doi: 10.1177/1753495X221094899. Epub 2022 Apr 19.
BACKGROUND
In April 2020, the diagnostic criteria for gestational diabetes mellitus (GDM) changed in Queensland, with the goal of reducing exposure of pregnant women to COVID-19.
METHODS
A retrospective clinical audit was conducted at a regional hospital to compare the incidence of GDM, and specific maternal and neonatal outcomes four months before and after the change in guidelines was implemented.
RESULTS
Less than 50% of diagnostic tests were performed according to new guidelines. There was a non-significant increase in the incidence of GDM (13.3% to 15.3%), and pharmacological treatments. Instrumental deliveries ( = 0.01) and shoulder dystocia ( = 0.04) increased following the change in guidelines. There were no differences in the incidence of elective and emergency caesarean delivery, macrosomia and fetal weight. Maternal pre-pregnancy body mass index (BMI) was higher in the COVID-19 GDM cohort ( = 0.02).
CONCLUSIONS
Despite the change in guidelines, there was a non-significant increase in the incidence of diagnosis of gestational diabetes.
背景
2020年4月，昆士兰州妊娠期糖尿病（GDM）的诊断标准发生了变化，目的是减少孕妇感染新冠病毒的风险。
方法
在一家地区医院进行了一项回顾性临床审计，以比较指南变更实施前后四个月GDM的发病率以及特定的孕产妇和新生儿结局。
结果
不到50%的诊断测试是按照新指南进行的。GDM的发病率（从13.3%增至15.3%）和药物治疗有不显著的增加。指南变更后，器械助产（P = 0.01）和肩难产（P = 0.04）有所增加。择期和急诊剖宫产、巨大儿和胎儿体重的发生率没有差异。新冠病毒感染的GDM队列中孕妇孕前体重指数（BMI）更高（P = 0.02）。
结论
尽管指南发生了变化，但妊娠期糖尿病的诊断发病率仍有不显著的增加。
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