Magnitude of Gestational Diabetes Mellitus, its Influencing Factors and Diagnostic Accuracy of Capillary Blood Testing for its Detection at a Tertiary Care Centre, Rajkot, Gujarat
Magnitude of Gestational Diabetes Mellitus, its Influencing Factors and Diagnostic Accuracy of Capillary Blood Testing for its Detection at a Tertiary Care Centre, Rajkot, Gujarat
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DOI：
10.4103/ijcm.ijcm_283_18
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发表时间：
2019-04-01
影响因子：
0.9
通讯作者：
Kamariya, Chandrakant P.
中科院分区：
文献类型：
--
作者：
Chudasama, Rajesh K.;Kadri, A. M.;Kamariya, Chandrakant P.
工作背景：妊娠期糖尿病（GDM）发生于妊娠期，影响母亲、胎儿和妊娠结局，因此早期发现是必要的。本研究的目的是确定血糖仪的有效性超过标准的生化测试检测GDM和估计GDM的患病率及其相关的危险因素。材料与方法：根据《GDM诊断和管理国家指南》，在三级保健医院产科的产科门诊进行了一项以医院为基础的研究。2016年1月至3月，共有357名孕龄在21至28周之间的孕妇参与了这项研究。在获得书面同意后，通过给予75 g无水葡萄糖溶解在200-250 ml水中，为孕妇提供一步程序。2小时后，通过血糖仪毛细血管测试估计血糖水平，通过葡萄糖氧化酶测试估计静脉血糖。结果：血糖仪检测GDM检出率为20.4%，静脉血检测GDM检出率为11.5%。GDM在识字者、家庭主妇、印度教徒、生活在核心家庭、中产阶级、居住在城市、孕妇、肥胖和胎龄在21 - 24周之间的人群中较高。两种方法的敏感性为70.7%，特异性为86.1%，阳性预测值为39.7%，阴性预测值为95.8%。结论：两种方法之间的中间一致性表明，血糖仪检测可用于筛查孕龄早期（21周）的孕妇，由卫生保健工作者在社区一级进行。
Background: Gestational diabetes mellitus (GDM) occurs during pregnancy which affects mother, fetus, and outcome of pregnancy, hence early detection is necessary. The objective of this study was to ascertain the validity of glucometer over standard biochemical testing for detection of GDM and to estimate prevalence of GDM and its associated risk factors. Materials and Methods: A hospital-based study was conducted at Antenatal clinics of Obstetrics Department, tertiary care hospital, based on the "National Guidelines for Diagnosis and Management of GDM." Totally 357 pregnant women between 21 and 28 weeks of gestational age agreed were included in the study from January to March 2016. After obtaining written consent, one step procedure was offered to pregnant women by giving 75 g of anhydrous glucose dissolving in 200-250 ml of water. After 2 h, glucose level was estimated by capillary testing with glucometer and venous glucose by glucose oxidase test. Results: GDM was found in 20.4% pregnant women with capillary testing done by glucometer compare to 11.5% with venous blood testing. GDM was found higher among literates, homemakers, Hindus, people living in nuclear family, belongs to middle class, residing in urban area, primigravidae, obese and with gestational age between 21 and 24 weeks. Intermediate agreement (Kappa = 0.42) was found between two methods with sensitivity of 70.7%, specificity of 86.1%, positive predictive value 39.7%, and negative predictive value 95.8%. Conclusion: Intermediate agreement between two methods indicates glucometer testing can be used to screen pregnant women at an early gestational age (21 weeks), at the community level by health-care workers.