López-de la Peña X A, Cájero Avelar J J, De León Romo L F
Unidad de Medicina Critica, Hospital General de Zona No. 1, Dr. José Luis Avila Pardo, Instituto Mexicano del Seguro Social, Aguascalientes, México.
Arch Med Res. 1997 Summer;28(2):281-4.
The objective of this work was to determine the prevalence and associated clinical variables of gestational diabetes in a group of pregnant women, using a prospective, longitudinal and comparative study. The setting where the study was performed was an urban General Hospital, and outpatient clinics of the Instituto Mexicano del Seguro Social in Aguascalientes City, Mexico. The subjects were 187 pregnant women receiving prenatal care in two health care outpatient clinics where they had given informed consent for a 1-year period. All selected women without a history of diabetes mellitus were studied and scheduled for a full oral glucose tolerance test (OGTT) performed at 24-28 weeks of gestation. Gestational diabetes was diagnosed according to the American Diabetes Association. Results are shown for comparative purposes in three groups: 167 women with normal OGTT, 7 women with one OGTT abnormal value, and 13 women with OGTT criteria for gestational diabetes. The study protocol was approved by the Institutional Review Board. We found a prevalence of 6.9% of gestational diabetes in our study group, and significant differences (p < 0.05) among parity, fasting blood glucose, macrosomy, family history of diabetes, obesity of 90 kg or more, and age > 35 years. Body mass index mean was over 25 kg/m2 in all groups. The 6.9% prevalence of gestational diabetes we found is higher than data between 3.9 and 6% previously reported in Mexico. This could reflect a selection bias of our sample; however, it represents a serious public health problem. Appropriate screening, diagnosis, monitoring, and treatment must be implemented.
本研究旨在通过一项前瞻性、纵向和对比性研究，确定一组孕妇中妊娠期糖尿病的患病率及相关临床变量。研究在一家城市综合医院以及墨西哥阿瓜斯卡连特斯市墨西哥社会保障局的门诊诊所进行。研究对象为187名在两家医疗门诊接受产前护理的孕妇，她们均已签署为期1年的知情同意书。所有入选的无糖尿病病史的女性均接受研究，并安排在妊娠24至28周时进行完整的口服葡萄糖耐量试验（OGTT）。妊娠期糖尿病根据美国糖尿病协会的标准进行诊断。为便于比较，结果分为三组呈现：167名OGTT正常的女性、7名有一项OGTT值异常的女性以及13名符合妊娠期糖尿病OGTT标准的女性。该研究方案已获得机构审查委员会的批准。我们发现研究组中妊娠期糖尿病的患病率为6.9%，并且在产次、空腹血糖、巨大儿、糖尿病家族史、体重90公斤及以上的肥胖情况以及年龄>35岁等方面存在显著差异（p<0.05）。所有组的体重指数平均值均超过25kg/m²。我们发现的6.9%的妊娠期糖尿病患病率高于墨西哥此前报道的3.9%至6%的数据。这可能反映了我们样本的选择偏差；然而，这代表了一个严重的公共卫生问题。必须实施适当的筛查、诊断、监测和治疗。
