To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to d...To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test （OGTT）. Receiver operation curve （ROC） was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG （ P 〈0.01 ）. Correlation coefficient was O. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.展开更多
Background: Currently pregnant women with abnormal glucose screening test (GCT), performed at 26?-?28 weeks gestation with a subsequent normal glucose tolerance test (GTT) receive routine care. Could these women be at...Background: Currently pregnant women with abnormal glucose screening test (GCT), performed at 26?-?28 weeks gestation with a subsequent normal glucose tolerance test (GTT) receive routine care. Could these women be at risk of adverse pregnancy? Objective: Compare rate of caesarean section (CS), induction of labour (IOL), macrosomia, admission to special care nursery and neonatal hypoglycaemia. Designs: Retrospective cohort study. Setting: Ipswich Hospital, Ipswich, Queensland. Participants: Pregnant women having had the test at the hospital laboratory. Methods: Charts review of outcome measures including induction of labour, caesarean section, macrosomia, RDS and short-term neonatal morbidity. Results: We reviewed 882 charts (441 cases and 441 controls). There was a higher IOL rate among cases 21.1% versus 16.6% (OR and 95% CI 1.45;1.03?-?2.06) and a higher CS rate, 30.4 versus 23.6 (OR and 95% CI 1.41;1.05?-?1.91). Compared to women with BMI 18.5 - 24.9, women with BMI of 30 and above had a significantly higher IOL rate (47.1% versus 22.6%), higher CS rate (47.2% versus 25.7%) and higher rate of macrosomic baby (79.2% versus 4.2%). There were more women amongst the cases who were older, smoked, had a BMI 30 and above and had previous history of GDM. After adjusting for maternal age, BMI and smoking status, there was still an increased odds of CS, IOL and macrosomia, but this did not reach statistical significance. Conclusion: Abnormal glucose screening test in the absence of gestational diabetes is associated with adverse pregnancy outcome. This is largely contributed by maternal obesity.展开更多
目的:探讨孕妇妊娠期糖尿病(GDM)的发生率,以及妊娠期有糖尿病相关高危因素者与无高危因素者葡萄糖耐量 试验异常的关系及对胎儿、新生儿的影响。方法:对孕中、晚期孕妇进行口服50 g葡萄糖筛查(50 g GCT),血糖≥7.8 mmol／L者做 正规糖...目的:探讨孕妇妊娠期糖尿病(GDM)的发生率,以及妊娠期有糖尿病相关高危因素者与无高危因素者葡萄糖耐量 试验异常的关系及对胎儿、新生儿的影响。方法:对孕中、晚期孕妇进行口服50 g葡萄糖筛查(50 g GCT),血糖≥7.8 mmol／L者做 正规糖耐量试验(OGTT)以明确诊断,并对诊断妊娠期糖耐量降低(GIGT)及GDM给予早期治疗,观察其妊娠结局。结果:50 g GCT阳性率为10.65％,GIGT及GDM发病率分别为3.80％及3.48％。经早诊断、早治疗的孕妇,妊娠并发症、巨大儿、围产儿窒息、 围产儿死亡率明显降低。结论:对所有孕妇进行早期50 g GCT筛查,并对GIGT、GDM进行早治疗,伴有高危因素的孕妇重点监测, 减少了母儿的病死率。展开更多
目的回顾性分析医院妊娠中期孕妇口服葡萄糖耐量试验(OGTT)检测结果,为广安市妊娠期糖尿病(GDM)的诊疗提供依据。方法选取2015年10月至2017年2月医院正常产检妊娠中期(孕24~28周)孕妇1 555例进行75 g OGTT,孕妇按年龄分为3组,即<25岁...目的回顾性分析医院妊娠中期孕妇口服葡萄糖耐量试验(OGTT)检测结果,为广安市妊娠期糖尿病(GDM)的诊疗提供依据。方法选取2015年10月至2017年2月医院正常产检妊娠中期(孕24~28周)孕妇1 555例进行75 g OGTT,孕妇按年龄分为3组,即<25岁组(A组,364例)、≥25~<35岁组(B组,997例)和≥35岁组(C组,194例),参照《妊娠合并糖尿病诊治指南(2014)》中的诊断标准统计GDM发病人数及检出率。结果该院GDM总检出率为11.57%,其中A,B,C组依次为5.22%,11.13%,25.77%,各组间比较,差异有统计学意义(P<0.05);餐后2 h血糖筛查阳性率最高(7.78%);孕妇随年龄增大,血糖水平呈上升趋势,GDM检出率升高。结论 GDM的发病率随年龄增大而增高,应加强孕期,尤其是高龄孕妇的血糖筛查。展开更多
基金Supported by grants from the Natrual Science Foundation of Shanghai, China (99ZB14071).
文摘To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test （OGTT）. Receiver operation curve （ROC） was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG （ P 〈0.01 ）. Correlation coefficient was O. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.
文摘Background: Currently pregnant women with abnormal glucose screening test (GCT), performed at 26?-?28 weeks gestation with a subsequent normal glucose tolerance test (GTT) receive routine care. Could these women be at risk of adverse pregnancy? Objective: Compare rate of caesarean section (CS), induction of labour (IOL), macrosomia, admission to special care nursery and neonatal hypoglycaemia. Designs: Retrospective cohort study. Setting: Ipswich Hospital, Ipswich, Queensland. Participants: Pregnant women having had the test at the hospital laboratory. Methods: Charts review of outcome measures including induction of labour, caesarean section, macrosomia, RDS and short-term neonatal morbidity. Results: We reviewed 882 charts (441 cases and 441 controls). There was a higher IOL rate among cases 21.1% versus 16.6% (OR and 95% CI 1.45;1.03?-?2.06) and a higher CS rate, 30.4 versus 23.6 (OR and 95% CI 1.41;1.05?-?1.91). Compared to women with BMI 18.5 - 24.9, women with BMI of 30 and above had a significantly higher IOL rate (47.1% versus 22.6%), higher CS rate (47.2% versus 25.7%) and higher rate of macrosomic baby (79.2% versus 4.2%). There were more women amongst the cases who were older, smoked, had a BMI 30 and above and had previous history of GDM. After adjusting for maternal age, BMI and smoking status, there was still an increased odds of CS, IOL and macrosomia, but this did not reach statistical significance. Conclusion: Abnormal glucose screening test in the absence of gestational diabetes is associated with adverse pregnancy outcome. This is largely contributed by maternal obesity.
文摘目的:探讨孕妇妊娠期糖尿病(GDM)的发生率,以及妊娠期有糖尿病相关高危因素者与无高危因素者葡萄糖耐量 试验异常的关系及对胎儿、新生儿的影响。方法:对孕中、晚期孕妇进行口服50 g葡萄糖筛查(50 g GCT),血糖≥7.8 mmol／L者做 正规糖耐量试验(OGTT)以明确诊断,并对诊断妊娠期糖耐量降低(GIGT)及GDM给予早期治疗,观察其妊娠结局。结果:50 g GCT阳性率为10.65％,GIGT及GDM发病率分别为3.80％及3.48％。经早诊断、早治疗的孕妇,妊娠并发症、巨大儿、围产儿窒息、 围产儿死亡率明显降低。结论:对所有孕妇进行早期50 g GCT筛查,并对GIGT、GDM进行早治疗,伴有高危因素的孕妇重点监测, 减少了母儿的病死率。
