The effects of implementing the International Association of Diabetes and Pregnancy Study Groups criteria for diagnosing gestational diabetes on maternal and neonatal outcomes.
The effects of implementing the International Association of Diabetes and Pregnancy Study Groups criteria for diagnosing gestational diabetes on maternal and neonatal outcomes.
复制标题
实施国际糖尿病和妊娠研究协会的影响，以诊断孕产妇和新生儿结局诊断妊娠糖尿病的标准。
DOI：
10.1371/journal.pone.0122261
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Hsieh TT
中科院分区：
文献类型：
--
作者：
Hung TH;Hsieh TT
2010年，国际糖尿病和妊娠研究组协会（IADPSG）推荐了一种筛查和诊断妊娠糖尿病（GDM）的新策略。然而，没有研究表明，采用IADPSG的建议，改善围产期结局。本研究的目的是评估实施IADPSG诊断GDM标准对孕产妇和新生儿结局的影响。以前，我们使用两步法（1小时，50克葡萄糖挑战试验，然后3小时，100克葡萄糖耐量试验，当指示）来筛选和诊断GDM。2011年7月，我们在常规产科护理中采纳了《国际艾滋病和艾滋病防治战略》的建议。在这项研究中，我们回顾性地比较了在实施IADPSG标准之前（P1，2009年1月1日至2010年12月31日）和之后（P2，2012年1月1日至2013年12月31日）妊娠24周后分娩的所有妇女的各种孕产妇和新生儿结局的发生率。妊娠合并多胎妊娠、胎儿染色体或结构异常和孕前糖尿病被排除。我们的研究结果表明，GDM的发病率从使用两步法的4.6%增加到使用IADPSG标准的12.4%。与P1的妇女相比，P2的妇女在怀孕期间体重增加较少，出生体重较低，产程较短，巨大儿（<4000 g）和大于胎龄儿（LGA）的发生率较低。多因素Logistic回归分析显示，P2是巨大儿和LGA的独立危险因素，校正OR为0.63，95%CI为0.43-0.90，校正OR为0.74，95%CI为0.61-0.89。采用IADPSG标准诊断GDM与妊娠期母体体重增加、出生体重、巨大儿和LGA发生率显著降低相关。
In 2010, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommended a new strategy for the screening and diagnosis of gestational diabetes mellitus (GDM). However, no study has indicated that adopting the IADPSG recommendations improves perinatal outcomes. The objective of this study was to evaluate the effects of implementing the IADPSG criteria for diagnosing GDM on maternal and neonatal outcomes. Previously, we used a two-step approach (a 1-h, 50-g glucose challenge test followed by a 3-h, 100-g glucose tolerance test when indicated) to screen for and diagnose GDM. In July 2011, we adopted the IADPSG recommendations in our routine obstetric care. In this study, we retrospectively compared the rates of various maternal and neonatal outcomes in all women who delivered after 24 weeks of gestation during the periods before (P1, between January 1, 2009 and December 31, 2010) and after (P2, between January 1, 2012 and December 31, 2013) the IADPSG criteria were implemented. Pregnancies complicated by multiple gestations, fetal chromosomal or structural anomalies, and pre-pregnancy diabetes mellitus were excluded. Our results showed that the incidence of GDM increased from 4.6% using the two-step method to 12.4% using the IADPSG criteria. Compared to the women in P1, the women in P2 experienced less weight gain during pregnancy, lower birth weights, shorter labor courses, and lower rates of macrosomia (<4000 g) and large-for-gestational age (LGA) infants. P2 was a significant independent factor against macrosomia (adjusted odds ratio [OR] 0.63, 95% confidence interval [CI] 0.43–0.90) and LGA (adjusted OR 0.74, 95% CI 0.61–0.89) after multivariable logistic regression analysis. The adoption of the IADPSG criteria for diagnosis of GDM was associated with significant reductions in maternal weight gain during pregnancy, birth weights, and the rates of macrosomia and LGA.
登录
查看更多内容
影响因子：
3.5
作者：
Lapolla, A.;Dalfra, M. G.;Fedele, D.
通讯作者：
Fedele, D.
影响因子：
9.8
作者：
Mission, John F.;Ohno, Mika S.;Caughey, Aaron B.
通讯作者：
Caughey, Aaron B.
DOI：
10.1136/bmj.c1395
发表时间：
2010-04-01
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Horvath K;Koch K;Jeitler K;Matyas E;Bender R;Bastian H;Lange S;Siebenhofer A
通讯作者：
Siebenhofer A
影响因子：
7.2
作者：
通讯作者：
--
影响因子：
2.8
作者：
Benhalima K;Hanssens M;Devlieger R;Verhaeghe J;Mathieu C
通讯作者：
Mathieu C