Abstract:
BACKGROUND:Two criteria based on a 2 h 75 g OGTT are being used for the diagnosis of gestational diabetes (GDM), those recommended over the years by the World Health Organization (WHO), and those recently recommended by the International Association for Diabetes in Pregnancy Study Group (IADPSG), the latter generated in the HAPO study and based on pregnancy outcomes. Our aim is to systematically review the evidence for the associations between GDM (according to these criteria) and adverse outcomes. METHODS:We searched relevant studies in MEDLINE, EMBASE, LILACS, the Cochrane Library, CINHAL, WHO-Afro library, IMSEAR, EMCAT, IMEMR and WPRIM. We included cohort studies permitting the evaluation of GDM diagnosed by WHO and or IADPSG criteria against adverse maternal and perinatal outcomes in untreated women. Only studies with universal application of a 75 g OGTT were included. Relative risks (RRs) and their 95% confidence intervals (CI) were obtained for each study. We combined study results using a random-effects model. Inconsistency across studies was defined by an inconsistency index (I2) > 50%. RESULTS:Data were extracted from eight studies, totaling 44,829 women. Greater risk of adverse outcomes was observed for both diagnostic criteria. When using the WHO criteria, consistent associations were seen for macrosomia (RR = 1.81; 95%CI 1.47-2.22; p < 0.001); large for gestational age (RR = 1.53; 95%CI 1.39-1.69; p < 0.001); perinatal mortality (RR = 1.55; 95% CI 0.88-2.73; p = 0.13); preeclampsia (RR = 1.69; 95%CI 1.31-2.18; p < 0.001); and cesarean delivery (RR = 1.37;95%CI 1.24-1.51; p < 0.001). Less data were available for the IADPSG criteria, and associations were inconsistent across studies (I2 ≥ 73%). Magnitudes of RRs and their 95%CIs were 1.73 (1.28-2.35; p = 0.001) for large for gestational age; 1.71 (1.38-2.13; p < 0.001) for preeclampsia; and 1.23 (1.01-1.51; p = 0.04) for cesarean delivery. Excluding either the HAPO or the EBDG studies minimally altered these associations, but the RRs seen for the IADPSG criteria were reduced after excluding HAPO. CONCLUSIONS:The WHO and the IADPSG criteria for GDM identified women at a small increased risk for adverse pregnancy outcomes. Associations were of similar magnitude for both criteria. However, high inconsistency was seen for those with the IADPSG criteria. Full evaluation of the latter in settings other than HAPO requires additional studies.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Wendland EM,Torloni MR,Falavigna M,Trujillo J,Dode MA,Campos MA,Duncan BB,Schmidt MIdoi
10.1186/1471-2393-12-23subject
Has Abstractpub_date
2012-03-31 00:00:00pages
23issn
1471-2393pii
1471-2393-12-23journal_volume
12pub_type
杂志文章,评审abstract:BACKGROUND:Early antenatal care (ANC) initiation is a doorway to early detection and management of potential complications associated with pregnancy. Although the literature reports various factors associated with ANC initiation such as parity and age, pregnancy intentions is yet to be recognized as a possible predicto...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-13-35
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abstract:BACKGROUND:Globally, an estimated 275,000 maternal deaths, 2.7 million neonatal deaths, and 2.6 million third trimester stillbirths occurred in 2015. Major improvements could be achieved by providing effective care in low- and middle-income countries, where the majority of these deaths occur. Mentoring programs have be...
journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1744-y
更新日期:2018-04-20 00:00:00
abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,已发布勘误
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更新日期:2020-07-30 00:00:00
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
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pub_type: 杂志文章
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abstract::BACKGROUND: Some currently available birth weight for gestational age standards are customized but others are not. We carried out a study to provide empirical justification for customizing such standards by sex and for whites and blacks in the United States. METHODS: We studied all male and female singleton live birth...
journal_title:BMC pregnancy and childbirth
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pub_type: 临床试验,杂志文章
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
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