孕期糖尿病查:美国预防服务工作组的最新证据报告和系统审查
Jennifer Pillay1, Lois Donovan2, Samantha Guitard1
1University of Alberta Evidence-based Practice Center, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
JAMA
|August 10, 2021
概括
孕期糖尿病 (GDM) 的查显示直接益处有限. 然而,怀孕24周后的GDM治疗显著改善了母亲和新生儿的健康结果.
科学领域:
- 产科和妇科
- 内分泌学
- 公共卫生
背景情况:
- 孕期糖尿病 (GDM) 与孕产妇和胎儿的健康状况有关.
- 美国预防服务工作组 (USPSTF) 要求更新关于GDM查和治疗的证据.
研究的目的:
- 审查关于GDM查及其对健康结果的影响的证据.
- 评估不同GDM查测试和治疗方案的准确性和有效性.
主要方法:
- 随机临床试验 (RCT),非随机干预研究和观察性研究的系统审查.
- 使用元分析和双变分析来综合查准确性和治疗疗效的数据.
- 包括2010年至2020年间发表的研究,监测到2021年6月.
主要成果:
- 有限的直接证据支持GDM查与不进行查的好处.
- 与两步查方法相比,单步查方法与更高的GDM诊断率有关,但没有改善健康结果.
- 在怀孕24周或之后开始的GDM治疗显著降低了初级剖腹产,肩膀缩,巨和新生儿重症监护室的风险.
结论:
- 目前关于GDM查益处的证据有限且不一致.
- 在关键的母亲和新生儿健康结果中,GDM治疗与显著的改善有关.
- 需要进一步研究以澄清GDM的最佳查策略.
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