妊娠期高血糖的患病率在全球范围增加,其不仅和围产期母亲和胎儿不良事件相关,而且增加母亲和子代远期患代谢性疾病的风险,然而目前关于妊娠期高血糖的诊治仍存在很多争议。2015年国际妇产科联盟（ International Federation of Gynecol...妊娠期高血糖的患病率在全球范围增加,其不仅和围产期母亲和胎儿不良事件相关,而且增加母亲和子代远期患代谢性疾病的风险,然而目前关于妊娠期高血糖的诊治仍存在很多争议。2015年国际妇产科联盟（ International Federation of Gynecology and Obstetrics, FIGO）提出了务实的指南,本文对指南中妊娠期高血糖分类、诊断、管理的要点进行解读。展开更多
Background The International Association of Diabetes and Pregnancy Study Group （IADPSG） recommended new diagnostic criteria for gestational diabetes mellitus （GDM） after extensive analyses of the Hyperglycemia and...Background The International Association of Diabetes and Pregnancy Study Group （IADPSG） recommended new diagnostic criteria for gestational diabetes mellitus （GDM） after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes （HAPO） study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. Methods A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group （NDDG） or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. Results According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% （P 〈0.01） respectively, and the prevalence of cesarean section （52.5% vs. 46.0%, P 〈0.01）, macrosomia （7.5% vs. 6.3%, P 〈0.05）, neonatal hypoglycemia （1.6% vs. 1.0%, P 〈0.01）, and perinatal death （0.5% vs. 0.2%, P 〈0.01）; the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section （62.3%） and macrosomia （14.8%） was the highest in untreated mild GDM patients. Conclusions Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.展开更多
文摘妊娠期高血糖的患病率在全球范围增加,其不仅和围产期母亲和胎儿不良事件相关,而且增加母亲和子代远期患代谢性疾病的风险,然而目前关于妊娠期高血糖的诊治仍存在很多争议。2015年国际妇产科联盟（ International Federation of Gynecology and Obstetrics, FIGO）提出了务实的指南,本文对指南中妊娠期高血糖分类、诊断、管理的要点进行解读。
文摘Background The International Association of Diabetes and Pregnancy Study Group （IADPSG） recommended new diagnostic criteria for gestational diabetes mellitus （GDM） after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes （HAPO） study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. Methods A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group （NDDG） or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. Results According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% （P 〈0.01） respectively, and the prevalence of cesarean section （52.5% vs. 46.0%, P 〈0.01）, macrosomia （7.5% vs. 6.3%, P 〈0.05）, neonatal hypoglycemia （1.6% vs. 1.0%, P 〈0.01）, and perinatal death （0.5% vs. 0.2%, P 〈0.01）; the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section （62.3%） and macrosomia （14.8%） was the highest in untreated mild GDM patients. Conclusions Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.
