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国家糖尿病数据组与世界卫生组织检测妊娠期糖尿病标准的比较。

Comparison of National Diabetes Data Group and World Health Organization criteria for detecting gestational diabetes mellitus.

作者信息

Deerochanawong C, Putiyanun C, Wongsuryrat M, Serirat S, Jinayon P

机构信息

Department of Medicine, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand.

出版信息

Diabetologia. 1996 Sep;39(9):1070-3. doi: 10.1007/BF00400656.

Abstract

We compared the criteria for diagnosis of gestational diabetes mellitus (GDM) of the National Diabetes Data Group (NDDG) and the World Health Organization (WHO) and studied the outcomes of pregnancy. A 50-g glucose screening test and 75-g oral glucose tolerance test (OGTT) were scheduled for 709 pregnant women in the same week between the 24th and 28th week of pregnancy. Blood glucose was measured 1 h after the 50-g glucose screening test and if found to be 7.8 mmol/l or more, a 100-g OGTT was scheduled within 7 days after a 75-g OGTT. The prevalence of GDM was found to be 1.4% (10/709) and 15.7% (111/709) by NDDG and WHO criteria (2 h > or = 7.8 mmol/l), respectively. Using NDDG criteria, all the GDM patients had abnormal 75-g OGTT by WHO criteria. NDDG and WHO criteria were significantly different when compared with normal OGTT by each criteria for age, BMI, pregnancy-induced hypertension, Caesarian delivery, macrosomia and neonatal hypoglycaemia. Of 14 women with macrosomic infants 6 had an abnormal WHO test while only 3 of 14 had an abnormal NDDG test. These findings suggest that WHO criteria GDM patients had significantly worse outcomes of pregnancy and fewer perinatal complications were missed than with the more cumbersome NDDG criteria, and no case of GDM as diagnosed by NDDG criteria was missed.

摘要

我们比较了美国国家糖尿病数据组(NDDG)和世界卫生组织(WHO)对妊娠期糖尿病(GDM)的诊断标准,并研究了妊娠结局。在妊娠第24至28周的同一周,为709名孕妇安排了50克葡萄糖筛查试验和75克口服葡萄糖耐量试验(OGTT)。在50克葡萄糖筛查试验后1小时测量血糖,如果发现血糖为7.8毫摩尔/升或更高,则在75克OGTT后7天内安排100克OGTT。根据NDDG和WHO标准(2小时血糖≥7.8毫摩尔/升),GDM的患病率分别为1.4%(10/709)和15.7%(111/709)。按照NDDG标准,所有GDM患者根据WHO标准75克OGTT均异常。将NDDG和WHO标准与正常OGTT在年龄、体重指数、妊娠高血压、剖宫产、巨大儿和新生儿低血糖等各项标准进行比较时,两者存在显著差异。在14名分娩巨大儿的妇女中,6名WHO试验异常,而14名中只有3名NDDG试验异常。这些发现表明,与更为繁琐的NDDG标准相比,WHO标准下的GDM患者妊娠结局明显更差,漏诊的围产期并发症更少,且没有漏诊一例按照NDDG标准诊断的GDM病例。

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