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Estimated impact of introduction of new diagnostic criteria for gestational diabetes mellitus

World Journal of Diabetes 2021年第6期12卷 868-882页

作者： Leon de Wit anna b zijlmans Doortje Rademaker Christiana A Naaktgeboren J Hans DeVries Arie Franx Rebecca C Painter bas b van Rijn Department of Obstetrics and Gynaecology University Medical Center UtrechtUtrecht 3584 EANetherlands Department of Obstetrics and Gynaecology Gelderse Vallei HospitalEde 6716 RPNetherlands Department of Obstetrics and Gynaecology Amsterdam University Medical Centers-Location AMCAmsterdam 1105 AZNetherlands Department of Obstetrics and Gynaecology Amsterdam University Medical Centers–Location AMCAmsterdam 1105 AZNetherlands Department of Endocrinology Amsterdam University Medical Centers–Location AMCAmsterdam 1105 AZNetherlands Department of Obstetrics and Fetal Medicine Erasmus MC Sophia Children HospitalRotterdam 3015 GDNetherlands

bACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly *** To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy *** We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically *** were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both *** compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy *** Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly *** to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean *** infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar scorebstantial increase in GDM *** diagnosed women are at increased risk for pregnancy adverse *** risk,however,seems to be lower than those identified by the

关键词： Diagnostic criteria Gestational diabetes Glucose tolerance test Incidence Pregnancy outcome

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