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巴西妊娠糖尿病患病率的系统评价和荟萃分析。

Gestational diabetes mellitus prevalence in Brazil: a systematic review and meta-analysis.

机构信息

Universidade Federal do Pampa, Uruguaiana, Brasil.

Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil.

出版信息

Cad Saude Publica. 2024 Sep 9;40(8):e00064919. doi: 10.1590/0102-311XEN064919. eCollection 2024.

Abstract

This study estimates gestational diabetes mellitus prevalence in Brazil. A systematic review was conducted with articles published between 2010 and 2021 on the PubMed, Scopus, Google Scholar, SciELO, LILACS and Virtual Health Library databases, as well as gray literature. Data were extracted using a standardized instrument together with the risk of bias assessment tool proposed by Hoy et al. A meta-analysis with robust variance and random effects was developed. Heterogeneity was verified using I2 and publication bias was assessed using funnel plot and Egger's test. Prevalence according to risk of bias, diagnostic criteria and country's regions was determined by subgroup analyses. A total of 32 studies were included, representing 21,942 women. gestational diabetes mellitus pooled prevalence was 14% (95%CI: 11.0; 16.0), considerably higher than estimates from previous studies. Regarding risk of bias, studies with low, medium, and high risk showed a pooled prevalence of 12%, 14% and 14%, respectively. Overall GRADE certainty of evidence rating was low. Most studies used the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria or the adapted IADPSG, showing a pooled prevalence of 15% and 14%, respectively. As for region, the pooled prevalence was higher in the Southeast (14%) and lower in the Central-West (9%). This is the first systematic review to provide evidence on gestational diabetes mellitus prevalence at a national level and to demonstrate considerable heterogeneity among articles and the influence of region, diagnostic criteria and study quality on the referred indicator.

摘要

本研究旨在估算巴西的妊娠糖尿病患病率。通过对 2010 年至 2021 年期间在 PubMed、Scopus、Google Scholar、SciELO、LILACS 和虚拟卫生图书馆数据库以及灰色文献中发表的文章进行系统评价,采用标准化工具提取数据,并使用 Hoy 等人提出的偏倚风险评估工具进行风险评估。采用稳健方差和随机效应进行荟萃分析。使用 I2 检验评估异质性,并通过漏斗图和 Egger 检验评估发表偏倚。通过亚组分析确定根据偏倚风险、诊断标准和国家区域的患病率。共纳入 32 项研究,涉及 21942 名女性。妊娠糖尿病的汇总患病率为 14%(95%CI:11.0;16.0),明显高于以往研究的估计值。关于偏倚风险,低、中、高风险的研究显示的汇总患病率分别为 12%、14%和 14%。总体证据质量的 GRADE 确定性评级为低。大多数研究使用国际妊娠糖尿病研究协会(IADPSG)标准或改编的 IADPSG,分别显示汇总患病率为 15%和 14%。就区域而言,东南部的汇总患病率较高(14%),中西部较低(9%)。这是第一项提供全国范围内妊娠糖尿病患病率证据的系统评价,并表明文章之间存在相当大的异质性,以及区域、诊断标准和研究质量对所指指标的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4146/11386532/a156ce56823e/1678-4464-csp-40-08-EN064919-gf1.jpg

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