WHO与IADPSG诊断标准关于妊娠期糖尿病诊断率的比较  

Study on the differences between WHO and IADPSG criteria for gestational diabetes mellitus

作　　者：李畅[1,2] 史琳涛[1,2] 李广琦[1,2] 周玲[1,3] 宋晓菲[1,2] 李翔[1,2] 杜建新[1,3] 刘彦君[1,2] 

机构地区：[1]安徽医科大学解放军第306医院临床学院 [2]解放军306医院内分泌科,北京100101 [3]解放军306医院妇产科,北京100101

出　　处：《中国糖尿病杂志》2014年第5期385-388,共4页Chinese Journal of Diabetes

基　　金：国家科技重大专项子课题(2011ZX09307-001-08)

摘　　要：目的 本研究通过对孕妇75g OGTT结果与妊娠结局关系的回顾分析,比较WHO及IADPSG标准对妊娠期糖尿病（GDM）诊断的异同,并对不同诊断标准下妊娠不良结局进行比较. 方法 回顾性分析2000年6月至2010年12月在解放军第306医院妇产科行孕检的初产单活胎产妇8943名,孕24～32周行75g OGTT.比较2种诊断标准下GDM患病率及妊娠不良结局,探讨其对妊娠不良结局风险评估的价值. 结果 本研究分为NGT组、符合WHO诊断标准组（W）、符合IADPSG诊断标准组（Ⅰ）、符合WHO而不符合IADPSG组（W-I）及符合IADPSG而不符合WHO组（I-W）.同时符合2种GDM诊断标准618例;符合2010年IADPSG GDM诊断标准835例（9.3％）;符合WHO GDM诊断标准1039例（11.6％）.其中217例（17.2％）仅符合IADPSG诊断标准;421例（33.5％）仅符合WHO诊断标准.与GNGT组相比,GDM各组孕妇年龄更大（P＜0.05）,巨大儿、低体重儿、新生儿窒息发生率均升高（P＜0.05）.结论 WHO诊断标准GDM发病率更高,但会漏诊17.2％符合IADPSG诊断标准的患者;IADPSG则会漏诊33.5％2 hPG异常的GDM患者.无论符合WHO还是IADPSG诊断标准的GDM患者,巨大儿发生率均高于GNGT者.Objective To retrospectively analyze the relationship between the results of 75 g OGTT （oral glucose tolerance test） and pregnancy outcomes, and to compare the similarities and differences between the WHO （World Health Organization） criteria and IADPSG （The International Association of Diabetes and Pregnancy Study Groups） criteria for GDM （gestational diabetes mellitus）, and to study the adverse pregnancy outcomes in the two kinds of different criteria. Methods Retrospective analysis on 8943 primiparity pregnant women with singleliving fetus who anderwent a 75 g OGTT test between 24 to 32 gestational weeks in department of obstetrics and gynecology was performde in the 306th hospital of Chinese PLA during 2000 to 2010. The morbidity and adverse pregnancy outcomes between the two kinds of diagnostic criteria was compared and the reliability of the assessment on the risk of adverse pregnancy outcomes was studied. Results The samples of this study are categorized into three groups： NGT group （cases showing normal glucose tolerance） ,W group （cases according with the WHO criteria）, I group （cases according with the IADPSG criteria）. Cases in the W group but not according with IADPSG criteria are subdivided as the W-I group, and cases in the I group but not according with WHO criteria are subdivided as the I-W group. No significant differences in gestational weeks used for OGTT were shownamong all groups. Of all 8943 women tested, 1039 cases are in the W group, accounting for 11. 6~835 cases are in the I group （9.3%）. Of all 1256 GDM cases （cases in either W or I group） ,618 cases conform to both criteria （49. 2%） ;421 cases are in the W-I group （33. 50//oo） ~217 cases are in I-W group （17.2%）. Compared with those in the GNGT group, four GDM groups showed that the ages of women are older, and that the macrosomia,low birth weight infants and neonatal asphyxia are significantly higher （P〈0. 05）. Conclusion The cases in W group have a higher morbidity than those in

关 键 词：妊娠期糖尿病 WHO诊断标准 IADPSG诊断标准 妊娠不良结局 

分 类 号：R714.256[医药卫生—妇产科学]