Should the IADPSG criteria be applied when diagnosing early-onset gestational diabetes?
Should the IADPSG criteria be applied when diagnosing early-onset gestational diabetes?
复制标题
DOI：
10.1016/j.diabres.2018.03.048
复制
发表时间：
2018-06-01
影响因子：
5.1
通讯作者：
Aoki, Shigeru
中科院分区：
文献类型：
--
作者：
Hagiwara, Yuko;Kasai, Junko;Aoki, Shigeru
目的：调查国际糖尿病与妊娠研究组 (IADPSG) 标准在日本被采用为标准的广泛解释是否适用于妊娠早期。 方法：我们通过比较早期妊娠诊断后接受妊娠期糖尿病 (GDM) 治疗的女性（早发型 GDM，n = 528）和中期妊娠后接受 GDM 治疗的女性，进行糖尿病相关不良妊娠结局的调查。诊断，这是国际标准（中期发作的 GDM，n = 147）。结果：早发 GDM 组（7.5 公斤）的妊娠体重明显低于中期发作 GDM 组（8.4 公斤）。早发型 GDM 组妊娠期高血压疾病的发生率较低（5.6% vs 8.8%，p = 0.085），但婴儿出生体重在各组之间没有显着差异。在巨大儿、大于胎龄（LGA）、小于胎龄（SGA）、低阿普加评分、肩难产、剖腹产、NICU入住、高胆红素血症、新生儿低血糖或呼吸窘迫综合征方面没有观察到组间差异。LGA的频率与孕前体重指数显着相关，但根据治疗开始时间的不同而没有差异。结论：我们无法发现有效性与妊娠中期 GDM 诊断后的治疗干预相比，根据 IADPSG 标准，妊娠早期 GDM 诊断后开始的治疗干预的比例。有人建议，IADPSG 在妊娠 24-28 周诊断 GDM 的标准不应通过更广泛的解释应用于妊娠早期的日本女性。 (c) 2018 Elsevier B.V 保留所有权利。
Aims: To investigate whether the broad interpretation of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria with application to the early pregnancy, which is adopted as the standard in Japan, is appropriate.Methods: We conducted this investigation by comparing diabetes-related adverse pregnancy outcomes among women treated for gestational diabetes mellitus (GDM) following an early-pregnancy diagnosis (early-onset GDM, n = 528) and those treated for GDM following a mid-pregnancy diagnosis, which is the international standard (Mid-term-onset GDM, n = 147).Results: Gestational weight gain was significantly lower in the early-onset GDM group (7.5 kg) than in the mid-term-onset GDM group (8.4 kg). The frequency of hypertensive disorders of pregnancy tended to be lower in the early-onset GDM group (5.6% vs 8.8%, p = 0.085), but infant birth weight did not differ significantly between the groups. No between-group difference was observed in macrosomia, large-for-gestational-age (LGA), small-for-gestational age (SGA), low Apgar score, shoulder dystocia, cesarean delivery, NICU admission, hyperbilirubinemia, neonatal hypoglycemia, or respiratory distress syndrome The frequency of LGA showed a significant association with pre-pregnancy body mass index, but did not differ according to the timing of therapy initiation.Conclusions: We could not find the effectiveness of therapeutic interventions initiated after GDM diagnosis in the early pregnancy based on the IADPSG criteria, compared with therapeutic interventions after a mid-pregnancy GDM diagnosis. It was suggested that the IADPSG criteria for diagnosing GDM at 24-28 weeks' gestation should not be applied to Japanese women in the early pregnancy by a broader interpretation. (c) 2018 Elsevier B.V All rights reserved.