Screening for gestational diabetes: The effect of varying blood glucose definitions in the prediction of adverse maternal and infant health outcomes
Screening for gestational diabetes: The effect of varying blood glucose definitions in the prediction of adverse maternal and infant health outcomes
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DOI：
10.1111/j.1479-828x.2007.00743.x
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发表时间：
2007-08-01
影响因子：
1.7
通讯作者：
Robinson, Jeffrey S.
中科院分区：
文献类型：
--
作者：
Dodd, Jodie M.;Crowther, Caroline A.;Robinson, Jeffrey S.
背景：妊娠期糖耐量受损和妊娠期糖尿病与母婴风险增加有关。关于筛查妊娠期糖尿病和糖耐量受损的优点以及所使用的临界值的不同定义，文献中存在相当大的不确定性。目的：评估不同水平的葡萄糖耐量在预测不良妊娠结局中的作用。方法：回顾队列研究，筛查口服葡萄糖负荷为50g的孕妇，然后对筛查阳性的孕妇进行正式的75g口服葡萄糖耐量试验(定义为血糖水平>；=7.8 mmol/L)。结果：共有16975名孕妇接受了血糖负荷试验筛查，其中1804名血糖负荷试验阳性的孕妇获得了妊娠结局信息。随着血糖值的升高，先兆子痫、剖宫产、肩部难产和新生儿低血糖的发生率明显增加。结论：即使接受治疗，母婴妊娠结局不良的风险也随着血糖受损程度的增加而增加。
Background: Impaired glucose tolerance in pregnancy and gestational diabetes are associated with increased maternal and fetal risks. There is considerable uncertainty in the literature relating to the merits of screening for gestational diabetes and impaired glucose tolerance, and variable definitions in the cut-off values to be used.Aims: To assess different levels of glucose intolerance in predicting adverse pregnancy outcomes.Methods: Retrospective cohort study involving screening pregnant women with a 50-g oral glucose load, followed by a formal 75-g oral glucose tolerance test for women who screened positive (defined as a plasma glucose level >= 7.8 mmol/L). Plasma glucose results were correlated with pregnancy and birth outcomes, and receiver-operator curves were constructed.Results: A total of 16 975 women were screened with a glucose challenge test, with pregnancy outcome information available for 1804 women who screened positive on glucose challenge test. With increasing plasma glucose values, there was a significant increase in pre-eclampsia, Caesarean section, shoulder dystocia and neonatal hypoglycaemia.Conclusions: The risk of adverse maternal and infant pregnancy outcomes increases with increasing levels of glucose impairment despite treatment.