妊娠糖尿病のスクリーニング:米国予防サービスタスクフォースの勧告声明

, Karina W Davidson¹, Michael J Barry²

¹Feinstein Institutes for Medical Research at Northwell Health, Manhasset, New York.

JAMA

|August 10, 2021

まとめ

妊娠24週以降の妊娠中の妊婦のスクリーニングは,母親と乳児の健康に適度な利点をもたらします. 24週前の早期スクリーニングは,その利益と害を決定するのに十分な証拠がない.

科学分野:

産婦人科
内分泌学
予防医療

背景:

妊娠中糖尿病 (GDM) は,米国における妊娠の5.8%~9.2%に影響し,母親と胎児の合併症のリスクを増大します.
合併症には妊娠前出血症,胎児マクロソミア,出産時の傷害,新生児低血糖症,母親と子供の長期的な健康問題があります.
USPSTF (米国予防サービスタスクフォース) は,GDMのスクリーニングと治療に関する証拠をレビューしました.

研究の目的:

GDMのスクリーニングの正確性,利益,害を評価する.
妊婦と新生児に対するGDM治療の利害を評価する.

主な方法:

USPSTFが依頼した体系的な調査
1型または2型糖尿病のない妊婦に焦点を当てた.
検診の精度,利益,GDM介入の害を評価した.

主要な成果:

妊娠24週またはそれ以降のGDMスクリーニングの適度な純利益の確実性
24週未満のスクリーニングの利点と害を決定するには,証拠は不十分です.
検診の目的は妊婦と胎児の健康状態を改善することです

結論:

USPSTFは,24週目以降の無症状の妊婦のGDMスクリーニングを推奨しています.
妊娠24週前までのスクリーニングを評価するには,現在の証拠は不十分です.
推奨された時間帯でのスクリーニングは,GDMに関連するリスクを軽減することができます.

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