The Risk for Glucose Intolerance after Gestational Diabetes Mellitus since the Introduction of the IADPSG Criteria: A Systematic Review and Meta-Analysis

被引:34
|
作者
Benhalima, Katrien [1 ]
Lens, Karen [2 ]
Bosteels, Jan [3 ]
Chantal, Mathieu [1 ]
机构
[1] Katholieke Univ Leuven, Univ Hosp Gasthuisberg, Dept Endocrinol, Herestr 49, B-3000 Leuven, Belgium
[2] Katholieke Univ Leuven, Univ Hosp Gasthuisberg, Med Sch, Herestr 49, B-3000 Leuven, Belgium
[3] Imelda Ziekenhuis, Dept Obstet & Gynecol, Imeldalaan 9, B-2820 Bonheiden, Belgium
关键词
gestational diabetes mellitus; International Association of Diabetes and Pregnancy Study Groups (IADPSG); postpartum; type; 2; diabetes; impaired glucose tolerance; glucose intolerance; stroke; myocardial infarction; diagnostic criteria; BETA-CELL FUNCTION; LONG-TERM RISK; FOLLOW-UP; INTERNATIONAL ASSOCIATION; CARDIOVASCULAR-DISEASE; WOMEN; HISTORY; TOLERANCE; PREGNANCY; RECOMMENDATIONS;
D O I
10.3390/jcm8091431
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of the study was to assess the postpartum risk for glucose intolerance since the introduction of the International Association of Diabetes and Pregnancy Study Groups' (IADPSG) criteria for gestational diabetes mellitus (GDM). Studies published since 2010 were included, which evaluated the risk for type 2 diabetes mellitus (T2DM), impaired glucose tolerance (IGT), and cardiovascular (CV) events in women with previous GDM compared to normal glucose tolerant women. We included forty-three studies, evaluating 4,923,571 pregnant women of which 5.8% (284,312) had a history of GDM. Five studies used IADPSG criteria (n = 6174 women, 1314 with GDM). The overall pooled relative risk (RR) for postpartum T2DM was 7.42 (95% CI: 5.99-9.19) and the RR for postpartum T2DM with IADPSG criteria was 6.45 (95% CI: 4.74-8.77) compared to the RR of 9.08 (95% CI: 6.96-11.85; p = 0.17) for postpartum T2DM based on other diagnostic criteria. The RR for postpartum IGT was 2.45 (95% CI: 1.92-3.13), independent of the criteria used. None of the available studies with IADPSG criteria evaluated the risk for CV events. Women with a history of GDM based on the IADPSG criteria have a similarly increased risk for postpartum glucose intolerance compared to GDM based on other diagnostic criteria. More studies with GDM based on the IADPSG criteria are needed to increase the quality of evidence concerning the long-term metabolic risk.
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页数:26
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