低危孕妇行妊娠期糖尿病筛选可行性研究

目的 :确定美国糖尿病协会 (ADA)推荐的妊娠期糖尿病筛选方案是否适合上海地区。方法 :1999年 5月～ 1999年 8月对上海地区 11家医院产前检查的 2 4～ 36孕周的 1910例孕妇 ,进行 75g口服葡萄糖耐量试验 (OGTT)。OGTT 3项指标中有 2项或 2项以上超过以下数值为妊娠期糖尿病 (GDM ) :空腹血糖值 (FBG) :5.3mmol L、服糖后 1h、2h(PG1、PG2 )值分别为 :10 .0mmol L、8.6mmol L。有一项异常者称为OGTT单项异常 (IGT)。比较低危人群组 (年龄 <2 5岁 ,孕前体重指数 <2 5kg m2 ,无家族糖尿病病史 ,无巨大儿、死胎、畸胎史 )及高危人群组GDM及IGT发病率的差异 ,及其两组围产儿预后和母亲妊娠高血压综合征发病的差异。结果 :1910例孕妇中低危人群组 4 0 5例 ,高危人群组 150 5例。GDM分别为 3例 (0 .74 % )和 52例 (3.4 6% )。IGT分别为 30例 (7.4 % )和 12 0例 (8.0 % ) ,低危人群组和高危人群组IGT者及GDM者中大于胎龄儿、巨大儿、剖宫产及妊高征发生率均无统计学差异 (P >0 .0 5)。结论 :ADA推荐的妊娠期糖尿病筛选方案不适合上海地区

Study on the necessity forlow -risk pre gnant women to be screened for gestational diabetes mellitus.

Objective:To determine whether the recommend of gestational diabete s screening test of American Diabetes Associzaion suit to Shanghai area.Methods:1910 pregnant women from 11 hospitals of Shanghai was perf ormed 75g oral glucose tolerance test (OGTT) at gestational 24～36 weeks from Ma y 199 9 to Aug 1999.GDM was diagnosed if two or more values of (OGTT) were met or exc eeded.Impaired glucose tolerance(IGT)was diagnosed if only o ne of three values of OGTT were met or exceeded.The difference of the prevalence of GDM,IGT,perinatal outcome and pregnancy induced hypertension were recorded i n low-risk population(age＜25 and prepregnancy body mass index＜25kg/m2 and no family diabetes history and no macrosomia,fetal death and teratosis)and high-ris k population. Results 405 cases of pregnant women were divided into low-risk group,and 1505 cases of pregnant women were divided into h igh-risk group.The incidence rate of GDM and IGT in low-risk and high-risk group was 0.74% and 3.46%,7.4% and 8.0% respectively.The number of macrosomia,cesarea n section and PIH of IGT and GDM in low-risk and high-risk group had no difference (P＞0.05). Conclusion:The plan that ADA reco mmended for screening GDM is not fit to Shanghai area.