Division of Maternal-Fetal Medicine, University of California, San Diego, San Diego, California, USA.
Curr Opin Obstet Gynecol. 2024 Apr 1;36(2):97-103. doi: 10.1097/GCO.0000000000000940. Epub 2024 Jan 15.
Rates of gestational diabetes mellitus (GDM) throughout the world continue to increase associated with the increasing rates of obesity. Given this epidemiologic burden, the importance of proper screening, diagnosis, and management cannot be understated. This review focuses on the current screening guidelines utilized throughout the world and new data recently published regarding the most optimal screening techniques and future directions for research.
Despite unanimous opinion that GDM warrants screening, the optimal screening regimen remains controversial. Notably, in the United States per the consensus recommendation by the American College of Obstetrics and Gynecology and the Society for Maternal-Fetal Medicine, a 2-step screening approach is often used. Recently, there have been multiple studies published that have compared the 1-step and 2-step screening process with respect to GDM incidence and perinatal outcomes. These new findings are summarized below.
Utilization of the 1-step screening as opposed to the 2-step screening results in an increased diagnosis of GDM without significant population level benefit in outcomes. However, these studies remain underpowered to allow for meaningful comparison of outcomes in those diagnosed with GDM.
全球妊娠糖尿病（GDM）的发病率持续上升，与肥胖率的上升有关。鉴于这种流行病学负担，适当的筛查、诊断和管理的重要性怎么强调都不过分。本综述重点介绍了目前在全球使用的筛查指南，以及最近发表的关于最佳筛查技术和未来研究方向的新数据。
尽管一致认为 GDM 需要进行筛查，但最佳的筛查方案仍存在争议。值得注意的是，在美国，根据美国妇产科医师学会和母胎医学学会的共识建议，通常采用两步筛查方法。最近，有多项研究比较了一步法和两步法筛查在 GDM 发生率和围产期结局方面的效果。以下是对这些新发现的总结。
与两步筛查相比，一步筛查可增加 GDM 的诊断率，但在结局方面没有显著的人群受益。然而，这些研究的效力仍然不足，无法对确诊 GDM 的患者的结局进行有意义的比较。
