Gaps in Diabetes Screening During Pregnancy and Postpartum
Gaps in Diabetes Screening During Pregnancy and Postpartum
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DOI：
10.1097/aog.0b013e3181fe424b
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发表时间：
2011-01-01
影响因子：
7.2
通讯作者：
Kaufman, Harvey W.
中科院分区：
文献类型：
--
作者：
Blatt, Amy J.;Nakamoto, Jon M.;Kaufman, Harvey W.
目的：在一个全国性的大样本孕妇中，估计妊娠期糖尿病（GDM）的筛查率和患病率以及产后糖尿病的筛查率和患病率。我们还估计了潜在的影响，新的国际糖尿病协会和妊娠研究组的建议，取代100克口服葡萄糖耐量试验（OGTT）与75克OGTT，对GDM患病率和妊娠期血浆葡萄糖检测practice.METHODS：我们确定了孕妇谁使用的实验室服务的探索诊断和GDM筛查和产后进行测试。根据现行的美国糖尿病协会/Carpenter-Coustan标准和新的国际糖尿病协会和妊娠研究组标准计算妊娠糖尿病患病率。百分之六十八（632，820/924，873）对在本研究期间使用Quest Diagnostics服务的受试者（即，不属于低风险年龄组的受试者）进行GDM筛查。在接受GDM筛查的整个成年妊娠人群（18-40岁）中，5%（40，955/842，993）在现行标准下检测结果呈阳性。19%（4，486/23，299）的GDM患者在6个月内接受了产后糖尿病检测。在Quest Diagnostics对孕妇进行的所有确证性GDM测试中，90%（148，749/166，085）是100 g OGTT。接受75克OGTT后，GDM的妇女人数将增加一倍，根据国际糖尿病协会和妊娠研究组criteria.CONCLUSION：许多妇女可能不会在怀孕期间接受GDM筛查。怀孕后的产后糖尿病筛查率仍然很低。采用新的国际糖尿病协会和妊娠研究组标准将需要对目前的临床实践进行重大改变。（Obstet Gynecol 2011; 117：61-8）DOI：10.1097/AOG.0b013e3181fe424b
OBJECTIVE: To estimate the screening rate and prevalence of gestational diabetes mellitus (GDM) and the screening rate and prevalence of postpartum diabetes, in a large, national sample of pregnant women. We also estimated the potential effects of the new International Association of Diabetes and Pregnancy Study Groups recommendations, which replace the 100-g oral glucose tolerance test (OGTT) with the 75-g OGTT, on GDM prevalence and gestational plasma glucose testing practices.METHODS: We identified pregnant women who used the laboratory services of Quest Diagnostics and who were screened for GDM and were tested postpartum. Gestational diabetes mellitus prevalence was calculated according to the current American Diabetes Association/Carpenter-Coustan criteria, and the new International Association of Diabetes and Pregnancy Study Groups criteria.RESULTS: Sixty-eight percent (632,820/924,873) of pregnant women aged 25 to 40 (ie, those not in a low-risk age group) who utilized the services of Quest Diagnostics during this study were screened for GDM. Of the entire adult pregnant population (ages 18-40) who received GDM screening, 5% (40,955/842,993) had positive test results under the current criteria. Nineteen percent (4,486/23,299) of those with GDM received postpartum diabetes testing within a 6-month period. Ninety percent (148,749/166,085) of all confirmatory GDM tests performed on pregnant women at Quest Diagnostics were the 100-g OGTT. The number of women with GDM after receiving the 75-g OGTT would have doubled under the International Association of Diabetes and Pregnancy Study Groups criteria.CONCLUSION: Many women may not be receiving GDM screening during pregnancy. Postpartum diabetes screening rates after pregnancy remain low. Adoption of the new International Association of Diabetes and Pregnancy Study Groups criteria would require a significant change in current clinical practice. (Obstet Gynecol 2011; 117:61-8) DOI: 10.1097/AOG.0b013e3181fe424b