Diagnosing gestational diabetes.
Diagnosing gestational diabetes.
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DOI：
10.1007/s00125-010-2005-4
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发表时间：
2011-03
期刊：
影响因子：
8.2
通讯作者：
Ryan, E. A.
中科院分区：
文献类型：
--
作者：
Ryan, E. A.
新提出的诊断妊娠糖尿病的标准将导致妊娠糖尿病患病率达到17.8%，使目前诊断的孕妇人数增加一倍。这些新的诊断标准主要基于高血糖不良妊娠结局（HAPO）研究中与出生大于胎龄儿（LGA）风险增加1.75倍相关的葡萄糖水平;他们使用单一OGTT。因此，在23，316例妊娠中，如果使用LGA的风险增加两倍，则4，150名女性而不是2，448名女性将被诊断为妊娠糖尿病。应该认识到，根据这些建议的标准，大多数LGA女性在怀孕期间血糖水平正常，母亲肥胖是LGA的更强预测因子。在这1，702名额外妇女中诊断妊娠期糖尿病的预期益处将是预防140例LGA，21例肩难产和16例产伤。OGTT诊断轻度高脂血症的重复性较差。考虑到（1）葡萄糖是LGA的弱预测因子，（2）治疗这些额外的数字具有适度的结果益处，以及（3）诊断可能基于单一的OGTT值升高，在分配资源以实施这一变化之前应该进行进一步的辩论。本文的在线版本（doi：10.1007/s00125 - 010 - 2005 - 4）包含补充材料，可供授权用户使用。
The newly proposed criteria for diagnosing gestational diabetes will result in a gestational diabetes prevalence of 17.8%, doubling the numbers of pregnant women currently diagnosed. These new diagnostic criteria are based primarily on the levels of glucose associated with a 1.75-fold increased risk of giving birth to large-for-gestational age infants (LGA) in the Hyperglycemia Adverse Pregnancy Outcome (HAPO) study; they use a single OGTT. Thus, of 23,316 pregnancies, gestational diabetes would be diagnosed in 4,150 women rather than in 2,448 women if a twofold increased risk of LGA were used. It should be recognised that the majority of women with LGA have normal glucose levels during pregnancy by these proposed criteria and that maternal obesity is a stronger predictor of LGA. The expected benefit of a diagnosis of gestational diabetes in these 1,702 additional women would be the prevention of 140 cases of LGA, 21 cases of shoulder dystocia and 16 cases of birth injury. The reproducibility of an OGTT for diagnosing mild hyperglycaemia is poor. Given that (1) glucose is a weak predictor of LGA, (2) treating these extra numbers has a modest outcome benefit and (3) the diagnosis may be based on a single raised OGTT value, further debate should occur before resources are allocated to implementing this change. The online version of this article (doi:10.1007/s00125-010-2005-4) contains supplementary material, which is available to authorised users.
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影响因子：
16.2
作者：
Gillman MW;Oakey H;Baghurst PA;Volkmer RE;Robinson JS;Crowther CA
通讯作者：
Crowther CA
影响因子：
7.7
作者：
Dabelea, D;Hanson, RL;Knowler, WC
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影响因子：
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作者：
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KNOWLER, WC
DOI：
10.1136/bmj.c1395
发表时间：
2010-04-01
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
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通讯作者：
Siebenhofer A
DOI：
10.1016/0002-9378(93)90019-f
发表时间：
1993-10-01
影响因子：
9.8
作者：
CATALANO, PM;AVALLONE, DA;AMINI, SB
通讯作者：
AMINI, SB