Gestational diabetes mellitus diagnosed with a 2-h 75-g gras glucose tolerance test and adverse pregnancy outcomes
Gestational diabetes mellitus diagnosed with a 2-h 75-g gras glucose tolerance test and adverse pregnancy outcomes
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DOI：
10.2337/diacare.24.7.1151
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发表时间：
2001-07-01
期刊：
影响因子：
16.2
通讯作者：
Yamashita, T
中科院分区：
文献类型：
--
作者：
Schmidt, MI;Duncan, BB;Yamashita, T
目的-评估美国糖尿病协会（ADA）和世界卫生组织（WHO）的诊断标准妊娠期糖尿病（GDM）对pregnancy outcomes.RESEARCH设计和方法-这项队列研究连续招收巴西成年妇女参加一般产前诊所。所有的妇女都被要求在估计的第24和第28孕周之间进行标准化的2小时75克口服葡萄糖耐量试验（OGTT），然后随访分娩。新的ADA GDM标准要求两个血糖值≥ 5.3 mmol/l（空腹）、≥ 10 mmol/l（1 h）和≥ 8.6 mmol/l（2 h）。WHO标准要求血糖≥ 7.0 mmol/l（空腹）或≥ 7.8 mmol/l（2 h）。结果-在4，977名研究的妇女中，2.4%（95%CI 2.0-2.9）按ADA标准和7.2%（6.5-7.9）按WHO标准出现GDM。在校正年龄、肥胖和其他危险因素的影响后，根据ADA标准，GDM预测巨大儿（RR 1.29，95%CI 0.73-2.18）、先兆子痫（2.28，1.22-4.16）和围产期死亡（3.10，1.42-6.47）的风险增加。同样，根据WHO标准，GDM预测巨大儿（1.45，1.06-1.95）、先兆子痫（1.94，1.22-3.03）和围产期死亡（1.59，0.86-2.90）的风险增加。在WHO标准阳性的妇女中，260例（73%）ADA标准阴性。相反，22（18%）妇女ADA标准呈阳性，WHO criterions.CONCLUSIONS - GDM的基础上2小时75克OGTT定义的世界卫生组织或ADA标准预测不良妊娠结局。
OBJECTIVE - To evaluate American Diabetes Association (ADA) and World Health Organization (WHO) diagnostic criteria for gestational diabetes mellitus (GDM) against pregnancy outcomes.RESEARCH DESIGN AND METHODS - This cohort study consecutively enrolled Brazilian adult women attending general prenatal clinics. All women were requested to under take a standardized 2-h 75-g oral glucose tolerance test (OGTT) between their estimated 24th and 28th gestational weeks and were then followed to delivery. New ADA criteria for GDM require two plasma glucose values greater than or equal to5.3 mmol/l (fasting), greater than or equal to 10 mmol/l(l h), and greater than or equal to8.6 mmol/l (2 h). WHO criteria require a plasma glucose greater than or equal to7.0 mmol/l (fasting) or greater than or equal to7.8 mmol/l (2 h). Individuals with hyperglycemia indicative of diabetes outside of pregnancy were excluded.RESULTS - Among the 4,977 women studied, 2.4% (95% CI 2.0-2.9) presented with GDM by ADA criteria and 7.2% (6.5-7.9) by WHO criteria. After adjustment for the effects of age, obesity, and other risk factors, GDM by ADA criteria predicted an increased risk of macrosomia (RR 1.29, 95% CI 0.73-2.18), preeclampsia (2.28, 1.22-4.16), and perinatal death (3.10, 1.42-6.47). Similarly, GDM by WHO criteria predicted increased risk for macrosomia (1.45, 1.06-1.95), preeclampsia (1.94, 1.22-3.03), and perinatal death (1.59, 0.86-2.90). Of women positive by WHO criteria, 260 (73%) were negative by ADA criteria. Conversely, 22 (18%) women positive by ADA criteria were negative by WHO criteria.CONCLUSIONS - GDM based on a 2-h 75-g OGTT defined by either WHO or ADA criteria predicts adverse pregnancy outcomes.