An increase in the incidence of gestational diabetes mellitus: Northern California, 1991-2000
An increase in the incidence of gestational diabetes mellitus: Northern California, 1991-2000
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DOI：
10.1097/01.aog.0000113623.18286.20
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发表时间：
2004-03-01
影响因子：
7.2
通讯作者：
Hedderson, MM
中科院分区：
文献类型：
--
作者：
Ferrara, A;Kahn, HS;Hedderson, MM
目的：患有妊娠糖尿病（GDM）的女性及其后代患糖尿病的风险增加。尽管美国报告糖尿病患病率有所增加，但尚不清楚 GDM 是否也出现这种趋势。我们检查了 1991 年至 2000 年间 GDM 的年度累积发病率趋势。 方法：对北加州 Kaiser Permanente 医疗护理计划成员中发生的 267,051 例 GDM 筛查妊娠进行了一项队列研究，占所有符合条件的妊娠的 86.8%。 结果：根据 美国糖尿病协会（96.5%）或世界卫生组织（3.5%）的诊断血浆葡萄糖阈值。另外 2,743 名孕妇经出院诊断确诊患有 GDM。 2000 年筛查的女性比 1991 年筛查的女性（平均 [标准差] 28.8 [6.0] 岁）稍大一些（平均 [标准差] 年龄 28.8 [6.0] 岁），并且更有可能来自少数族裔群体（非洲裔美国人、亚洲人、西班牙裔和其他人分别为 51.4% 和 37.3%）。年龄和种族调整后的 GDM 年累积发病率从 1991 年的 5.1% 稳步上升至 1997 年的 7.4%，并在 2000 年趋于稳定 (6.9%)。 讨论：观察到的 GDM 年累积发病率的增长与研究人群年龄和种族的变化无关。 GDM 发病率的真正增加可能反映或导致糖尿病和肥胖症患病率的增加。需要协调一致的努力来改变这一趋势并预防 GDM 患者及其后代的慢性糖尿病。 (C) 2004 年，美国妇产科医师学会。
OBJECTIVE: Women with gestational diabetes mellitus (GDM) and their offspring are at increased risk of developing diabetes. Although increases in diabetes prevalence have been reported in the United States, it is unknown whether this trend is also occurring for GDM. We examined trends in the yearly cumulative incidence of GDM between the years 1991 and 2000.METHODS: A cohort study of 267,051 pregnancies screened for GDM that occurred among members of the Northern California Kaiser Permanente Medical Care Program, representing 86.8% of all eligible pregnancies, was undertaken.RESULTS: GDM was identified in 14,175 pregnancies according to the diagnostic plasma glucose thresholds of the American Diabetes Association (96.5%) or the World Health Organization (3.5%). An additional 2,743 pregnant women with GDM were identified by a hospital discharge diagnosis. The women screened in 2000 were slightly older (mean [standard deviation] age 28.8 [6.0] years) than were those screened in 1991 (28.2 [5.7] years) and more likely to be from minority ethnic groups (51.4% versus 37.3% identified as African American, Asian, Hispanic, and other). The age- and ethnicity-adjusted yearly cumulative incidence of GDM increased steadily from 5.1% in 1991 to 7.4% in 1997 and leveled off through 2000 (6.9%).DISCUSSION: The observed increase in yearly cumulative incidence of GDM was independent of changes in age and ethnicity of the study population. A true increase in GDM incidence might reflect or contribute to the increases in the prevalence of diabetes and obesity. Coordinated efforts are needed to alter this trend and to prevent chronic diabetes in GDM patients and their offspring. (C) 2004 by The American College of Obstetricians and Gynecologists.