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中华产科急救电子杂志 ›› 2021, Vol. 10 ›› Issue (01) : 6 -10. doi: 10.3877/cma.j.issn.2095-3259.2021.01.002

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妊娠期糖尿病筛查的方法及评价
许煌坊1, 李笑天1,()   
  1. 1. 200011 上海,复旦大学附属妇产科医院 上海市女性生殖内分泌相关疾病重点实验室 上海市生物医学科学研究所
  • 收稿日期:2020-12-01 出版日期:2021-02-18
  • 通信作者: 李笑天
  • 基金资助:
    国家"十三五"规划重大项目(2016YFC1000400); 国家重点基础研究发展规划(973计划)(2015CB943300); 上海市临床科技创新重点项目(18511105602); 上海市女性生殖疾病重点临床医学中心(2017ZZ01016)

Screening methods and evaluation of gestational diabetes mellitus

Huangfang Xu1, Xiaotian Li1()   

  • Received:2020-12-01 Published:2021-02-18
  • Corresponding author: Xiaotian Li
引用本文:

许煌坊, 李笑天. 妊娠期糖尿病筛查的方法及评价[J]. 中华产科急救电子杂志, 2021, 10(01): 6-10.

Huangfang Xu, Xiaotian Li. Screening methods and evaluation of gestational diabetes mellitus[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2021, 10(01): 6-10.

妊娠期糖尿病(gestational diabetes mellitus, GDM)是影响妊娠结局的主要危险因素之一,与母儿近、远期不良妊娠结局密切相关。近年来,随着人们生活水平的提升和饮食习惯的改变,GDM的发病率呈现逐年增长的趋势,且越来越年轻化,及时筛查并给予有效的干预与治疗措施是降低GDM发病率及减少妊娠期相关并发症的关键。本文就不同的GDM的筛查策略进行综合分析,为改善母婴结局提供选择。

Gestational diabetes mellitus (GDM) is one of the main risk factors affecting pregnancy outcomes, which is closely related to the adverse pregnancy outcomes of mothers and infants in the near and long term. In recent years, with the improvement of living standards and changes in dietary habits, the incidence rate of GDM has been increasing year by year, and is becoming younger. Timely screening and effective intervention and treatments are the key to decrease the incidence rate of GDM and reduce the complications during pregnancy. In this paper, different screening strategies for GDM is comprehensively analyzed to provide options for improving maternal and infant outcomes.

[1]
Zhang XQ, Xiao YS. The Association Between Trimester-Specific Weight Gain and Severe Preeclampsia/Adverse Perinatal Outcome in Gestational Diabetes Mellitus Complicated by Preeclampsia: A Retrospective Case Study [J]. Diabetes Ther, 2019, 10(2): 725-734.
[2]
Catalano PM, McIntyre HD, Cruickshank JK, et al. HAPO Study Cooperative Research Group. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes [J]. Diabetes Care, 2012, 35(4): 780-786.
[3]
Nguyen-Ngo C, Jayabalan N, Salomon C, et al. Molecular pathways disrupted by gestational diabetes mellitus[J]. J Mol Endocrinol, 2019, 63(3): R51-R72.
[4]
Zhu WW, Yang HX, Wei YM, et al. Evaluation of the value of fasting plasma glucose in the first prenatal visit to diagnose gestational diabetes mellitus in china[J]. Diabetes Care, 2013, 36(3): 586-590.
[5]
Consensus Development Panel. National Institutes of Health consensus development conference statement: diagnosing gestational diabetes mellitus, March 4-6, 2013 [J]. Obstet Gynecol, 2013, 122(2 Pt 1): 358-369.
[6]
Aaron B, Caughey MT. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus [J]. Obstet Gynecol, 2018, 131(2): e49-e64.
[7]
Sovio U, Murphy HR, Smith GC. Accelerated Fetal Growth Prior to Diagnosis of Gestational Diabetes Mellitus: A Prospective Cohort Study of Nulliparous Women [J]. Diabetes Care, 2016, 39(6): 982-987.
[8]
Moyer VA, Preventive Services Task Force. Screening for gestational diabetes mellitus: U. S. Preventive Services Task Force recommendation statement[J]. Ann Intern Med, 2014, 160(6): 414-420.
[9]
Landon MB, Spong CY, Thom E, et al. A multicenter, randomized trial of treatment for mild gestational diabetes [J]. N Engl J Med, 2009, 361(14): 1339-1348.
[10]
Palatnik A, Mele L, Landon MB, et al. Timing of treatment initiation for mild gestational diabetes mellitus and perinatal outcomes [J]. Am J Obstet Gynecol, 2015, 213(4): 560.e1-8.
[11]
American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018[J]. Diabetes Care, 2018, 41(Suppl 1): S13-S27.
[12]
Lowe WL, Lowe LP, Kuang A, et al. Maternal glucose levels during pregnancy and childhood adiposity in the Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study [J]. Diabetologia, 2019, 62(4): 598-610.
[13]
谢幸,苟文丽.妇产科学 [M].8版. 北京:人民卫生出版社,2013:76-77.
[14]
Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes [J]. Am J Obstet Gynecol, 1982, 144(7): 768-773.
[15]
Lanni S, Barrett D. The predictive value of the 1-h 50-g glucose screen for diagnosing gestational diabetes mellitus in a high-risk population [J]. J Matern Fetal Neonatal Med, 2004, 15(6): 375-379.
[16]
Cheng YW, Esakoff TF, Block-Kurbisch I, et al. Screening or diagnostic: Markedly elevated glucose loading test and perinatal outcomes [J]. J Matern Fetal Neonatal Med, 2006, 19(11): 729-734.
[17]
Temming LA TM, Stout MJ, Macones GA, et al. Diagnostic Ability of Elevated 1-hour Glucose Challenge Test[J]. J Perinatol, 2016, 36(5): 342-346.
[18]
Van Leeuwen M, Louwerse MD, Opmeer BC, et al. Glucose challenge test for detecting gestational diabetes mellitus: a systematic review [J]. BJOG, 2012, 119(4): 393-401.
[19]
Roeckner JT, Sanchez-Ramos L, Jijon-Knupp R, et al. Single abnormal value on 3-hour oral glucose tolerance test during pregnancy is associated with adverse maternal and neonatal outcomes: a systematic review and metaanalysis [J]. Am J Obstet Gynecol, 2016, 215(3): 287-297.
[20]
Crowther CA, Hiller JE, Moss JR, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes [J]. N Engl J Med, 2005, 352(24): 2477-286.
[21]
Saccone G, Caissutti C, Khalifeh A, et al. One step versus two step approach for gestational diabetes screening: systematic review and meta-analysis of the randomized trials[J]. J Matern Fetal Neonatal Med, 2019, 32(9): 1547-1555.
[22]
Caissutti C, Khalifeh A, Saccone G, et al. Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes [J]. Acta Obstet Gynecol Scand, 2018, 97(2): 122-134.
[23]
Bonis C, Lorenzini F, Bertrand M, et al. Glucose Profiles in Pregnant Women After a Gastric Bypass: Findings from Continuous Glucose Monitoring [J]. Obes Surg, 2016, 26(9): 2150-2155.
[24]
Yu F, Lv L, Liang Z, et al. Continuous glucose monitoring effects on maternal glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus: a prospective cohort study [J]. J Clin Endocrinol Metab, 2014, 99(12): 4674-4682.
[25]
Yu Q, Aris IM, Tan KH, et al. Application and Utility of Continuous Glucose Monitoring in Pregnancy: A Systematic Review[J]. Front Endocrinol (Lausanne), 2019, 10: 697.
[26]
Saeedi M, Hanson U, Simmons D, et al. Characteristics of different risk factors and fasting plasma glucose for identifying GDM when using IADPSG criteria: a cross-sectional study [J]. BMC Pregnancy Childbirth, 2018, 18(1): 225.
[27]
d′Emden M, McLeod D, Ungerer J, et al. Development of a fasting blood glucose-based strategy to diagnose women with gestational diabetes mellitus at increased risk of adverse outcomes in a COVID-19 environment [J]. PLoS One, 2020, 15(12): e0243192.
[28]
Zawiejska A, Wróblewska-Seniuk K, Gutaj P, et al. Early Screening for Gestational Diabetes Using IADPSG Criteria May Be a Useful Predictor for Congenital Anomalies: Preliminary Data from a High-Risk Population [J]. J Clin Med, 2020, 9(11): 3553.
[29]
Shao B, Mo M, Xin X, et al. The interaction between prepregnancy BMI and gestational vitamin D deficiency on the risk of gestational diabetes mellitus subtypes with elevated fasting blood glucose [J]. Clin Nutr, 2020, 39(7): 2265-2273.
[30]
Sacks DA, Chen W, Wolde-Tsadik G, et al. Fasting plasma glucose test at the first prenatal visit as a screen for gestational diabetes [J]. Obstet Gynecol, 2003, 101(6): 1197-1203.
[31]
Hinkle SN, Tsai MY, Rawal S, et al. HbA1c Measured in the First Trimester of Pregnancy and the Association with Gestational Diabetes [J]. Sci Rep, 2018, 8(1): 12249.
[32]
Mendes N, Alves M, Andrade R, et al. Association between glycated albumin, fructosamine, and HbA1c with neonatal outcomes in a prospective cohort of women with gestational diabetes mellitus [J]. Int J Gynaecol Obstet, 2019, 146(3): 326-332.
[33]
Lai Y, Chen H, Du Z, et al. The diagnostic accuracy of HbA1c in detecting gestational diabetes mellitus among Chinese pregnant individuals [J]. Ann Transl Med, 2020, 8(16): 1014.
[34]
Agarwal MM, Punnose J, Dhatt GS. Gestational diabetes: problems associated with the oral glucose tolerance test [J]. Diabetes Res Clin Pract, 2004, 63(1): 73-74.
[35]
Schwartz JG, Phillips WT, Blumhardt MR, et al. Use of a more physiologic oral glucose solution during screening for gestational diabetes mellitus [J]. Am J Obstet Gynecol, 1994, 171(3): 685-691.
[36]
McIntyre HD. Discovery, Knowledge, and Action-Diabetes in Pregnancy Across the Translational Spectrum: The 2016 Norbert Freinkel Award Lecture [J]. Diabetes Care, 2018, 41(2): 227-232.
[37]
Zawiejska A, Wróblewska-Seniuk K, Gutaj P, et al. Early Screening for Gestational Diabetes Using IADPSG Criteria May Be a Useful Predictor for Congenital Anomalies: Preliminary Data from a High-Risk Population [J]. J Clin Med, 2020, 9(11): 3553.
[38]
Eriksen NB, Damm P, Mathiesen ER, et al. The prevalence of congenital malformations is still higher in pregnant women with pregestational diabetes despite near-normal HbA1c: a literature review [J]. J Matern Fetal Neonatal Med, 2019, 32(8): 1225-1229.
[39]
Metzger BE, Gabbe SG, Persson B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy [J]. Diabetes Care, 2010, 33(3): 676-682.
[40]
Zhang CC, Yang YX, Chen RY, et al. Aberrant expression of oxidative stress related proteins affects the pregnancy outcome of gestational diabetes mellitus patients [J]. Am J Transl Res, 2019, 11(1): 269-279.
[41]
Wang J, Chen K, Jin X, et al. Prognostic factors for cesarean section outcome of pregnant women with gestational diabetes mellitus: a systematic review and meta-analysis [J]. Diabetes Metab Syndr Obes, 2019, 12: 913-929.
[42]
Yang W, Liu J, Li J, et al. Interactive effects of prepregnancy overweight and gestational diabetes on macrosomia and large for gestational age: A population-based prospective cohort in Tianjin, China [J]. Diabetes Res Clin Pract, 2019, 154: 82-89.
[43]
Kuo CH, Li HY. Diagnostic Strategies for Gestational Diabetes Mellitus: Review of Current Evidence [J]. Curr Diab Rep, 2019, 19(12): 155.
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