Gestational diabetes in the United States: temporal changes in prevalence rates between 1979 and 2010.
Gestational diabetes in the United States: temporal changes in prevalence rates between 1979 and 2010.
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DOI：
10.1111/1471-0528.14236
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发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Ananth CV
中科院分区：
文献类型：
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作者：
Lavery JA;Friedman AM;Keyes KM;Wright JD;Ananth CV
研究年龄-时期-队列对美国妊娠糖尿病 (GDM) 患病率趋势的影响，并评估这些趋势如何影响死产率和大于胎龄 (LGA)/巨大儿率。回顾性队列研究。美国，1979-2010。超过 1.25 亿次怀孕（3 337 284 例 GDM 病例）与住院治疗有关。通过加权泊松模型检查 GDM 患病率的趋势，以解析 GDM 趋势在多大程度上可归因于产妇年龄、分娩周期和产妇出生队列。使用多水平模型来评估人口效应对 GDM 发生率的影响。使用对数线性泊松回归模型来估计 1979-81 年和 2008-10 年间 GDM 率上升对 LGA 和死产率变化的贡献。费率和费率比 (RR)。与1979-1980年（0.3%）相比，2008-10年GDM发病率上升至5.8%，具有较强的时期效应。显着的年龄效应和适度的队列效应是显而易见的。体重指数（BMI）、种族和母亲吸烟的时期趋势可以部分解释周期性效应。与 1979-81 年相比，2008-10 年 GDM 患病率的增加与 LGA/巨大儿发生率下降 184%（95% CI 180-188%）以及死产率增加 0.75%（95% CI 0.74-0.76）相关。 GDM 的暂时增加可归因于妊娠期和年龄。 BMI 的增加似乎是美国 GDM 增加的部分原因。
To examine age–period–cohort effects on trends in gestational diabetes mellitus (GDM) prevalence in the US, and to evaluate how these trends have affected the rates of stillbirth and large for gestational age (LGA)/macrosomia. Retrospective cohort study. USA, 1979–2010. Over 125 million pregnancies (3 337 284 GDM cases) associated with hospitalisations. Trends in GDM prevalence were examined via weighted Poisson models to parse out the extent to which GDM trends can be attributed to maternal age, period of delivery, and maternal birth cohort. Multilevel models were used to assess the contribution of population effects to the rate of GDM. Log-linear Poisson regression models were used to estimate the contributions of the increasing GDM rates to changes in the rates of LGA and stillbirth between 1979–81 and 2008–10. Rates and rate ratios (RRs). Compared with 1979–1980 (0.3%), the rate of GDM has increased to 5.8% in 2008–10, indicating a strong period effect. Substantial age and modest cohort effects were evident. The period effect is partly explained by period trends in body mass index (BMI), race, and maternal smoking. The increasing prevalence of GDM is associated with a 184% (95% CI 180–188%) decline in the rate of LGA/macrosomia and a 0.75% (95% CI 0.74–0.76) increase in the rate of stillbirths for 2008–10, compared with 1979–81. The temporal increase in GDM can be attributed to period of pregnancy and age. Increasing BMI appears to partially contribute to the GDM increase in the US.