Global estimates of the prevalence of hyperglycaemia in pregnancy
Global estimates of the prevalence of hyperglycaemia in pregnancy
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DOI：
10.1016/j.diabres.2013.11.003
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发表时间：
2014-02-01
影响因子：
5.1
通讯作者：
Cho, N. H.
中科院分区：
文献类型：
--
作者：
Guariguata, L.;Linnenkamp, U.;Cho, N. H.
目的：我们估计了 2013 年全球和 IDF 地区妊娠期出现高血糖的活产人数，包括妊娠期糖尿病（已知和之前未诊断的糖尿病）和妊娠期糖尿病。方法：使用 PubMed 并通过查阅引用的文献，确定了报告妊娠期首次检测到的高血糖（以前称为妊娠期糖尿病）患病率的研究。开发了一个简单的评分系统来描述诊断标准、研究进行年份、研究设计和代表性方面的研究特征。选择纳入至少三个年龄组的、具有足够详细的表征和报告方法的国家得分最高的研究。来自 34 个国家的 47 项研究被用来计算 20-49 岁女性在怀孕期间首次检测到的高血糖的特定年龄患病率。然后进行调整，以考虑研究中筛查方法和血糖诊断阈值的异质性，并与世界卫生组织最近发布的针对妊娠期首次检测到的高血糖定义的诊断标准保持一致。将患病率应用于生育率和人口估计，以确定 2013 年区域和全球妊娠期高血糖患病率。使用 IDF 糖尿病图谱中针对年龄和性别的糖尿病估计值计算了由于妊娠期糖尿病引起的妊娠期高血糖病例比例的估计值，并将其应用于特定年龄的生育率。结果：全球女性（20-49 岁）妊娠期高血糖患病率为 16.9%，或2013 年有 2140 万活产婴儿。估计其中 16.0% 的病例可能是由于妊娠期糖尿病所致。东南亚地区患病率最高，为 25.0%，而北美和加勒比地区为 10.4%。据估计，超过 90% 的妊娠期高血糖病例发生在低收入和中等收入国家。 结论：这是对妊娠期高血糖的首次全球估计，符合世界卫生组织关于诊断的新建议，并且还包括对已知患有糖尿病的妇女的活产的估计。它们从公共卫生和孕产妇和儿童健康的角度表明了该疾病的重要性，特别是在发展中国家。 (C) 2013 Elsevier Ireland Ltd. 保留所有权利。
Aims: We estimated the number of live births worldwide and by IDF Region who developed hyperglycaemia in pregnancy in 2013, including total diabetes in pregnancy (known and previously undiagnosed diabetes) and gestational diabetes.Methods: Studies reporting prevalence of hyperglycaemia first-detected in pregnancy (formerly termed gestational diabetes) were identified using PubMed and through a review of cited literature. A simple scoring system was developed to characterise studies on diagnostic criteria, year study was conducted, study design, and representation. The highest scoring studies by country with sufficient detail on methodology for characterisation and reporting at least three age-groups were selected for inclusion. Forty-seven studies from 34 countries were used to calculate age-specific prevalence of hyperglycaemia first-detected in pregnancy in women 20-49 years. Adjustments were then made to account for heterogeneity in screening method and blood glucose diagnostic threshold in studies and also to align with recently published diagnostic criteria as defined by the WHO for hyperglycaemia first detected in pregnancy. Prevalence rates were applied to fertility and population estimates to determine regional and global prevalence of hyperglycaemia in pregnancy for 2013. An estimate of the proportion of cases of hyperglycaemia in pregnancy due to total diabetes in pregnancy was calculated using age- and sex-specific estimates of diabetes from the IDF Diabetes Atlas and applied to age-specific fertility rates.Results: The global prevalence of hyperglycaemia in pregnancy in women (20-49 years) is 16.9%, or 21.4 million live births in 2013. An estimated 16.0% of those cases may be due to total diabetes in pregnancy. The highest prevalence was found in the South-East Asia Region at 25.0% compared with 10.4% in the North America and Caribbean Region. More than 90% of cases of hyperglycaemia in pregnancy are estimated to occur in low- and middle-income countries.Conclusion: These are the first global estimates of hyperglycaemia in pregnancy and conform to the new WHO recommendations regarding diagnosis and also include estimates of live births in women with known diabetes. They indicate the importance of the disease from a public health and maternal and child health perspective, particularly in developing countries. (C) 2013 Elsevier Ireland Ltd. All rights reserved.