RISS 검색 - 국내학술지논문 상세보기

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다국어 초록 (Multilingual Abstract)

Objective: American College of obstetricians and Gynecologists (ACOG) changed the screening strategy for early detection of gestational diabetes mellitus (GDM) or type 2 DM, which had been established by American Diabetes Association in 2017. The new strategy is the same with the strategy for detecting type 2 DM for asymptomatic adults. However there is not enough information about how the strategy is suitable for detecting GDM. We evaluated diagnostic performance of the new strategy for the detection of GDM in Korean Women.
Methods: Study population included enrolled singleton nondiabetic women during 3 years from November 2014 to October 2017. Maternal fasting blood was taken and measured for laboratory parameters at 10-14weeks of gestation. GDM was diagnosed by the two step approaches, which are screening using 50g oral glucose tolerance test (OGTT) and then following 100g OGTT. The high risk population of the new strategy was defined as overweight women who have one or more of the risk factors including family history of DM, history of cardiovascular disease, GDM or polycystic ovarian syndrome, physical inactivity, dyslipidemia including triglyceride >250mg/dL or high density lipoprotein < 35mg/dL, impaired glucose metabolism and hypertension. The odds ratio of risk factors was calculated by multivariate logistic regression.
Results: Among 1,077 pregnant women, 62 (5.8%) women was diagnosed for GDM and 20 (1.9%) women with GDM were managed on insulin. Prepregnancy obesity (aOR 4.41), previous GDM (aOR 5.85), impaired fasting glucose (aOR 12.93), triglyceride >250mg/dL (aOR 14.72) were remained after adjustment for confounding variables.
Conclusion: Prepregnancy obesity, previous GDM, impaired fasting glucose, and high triglyceride level were independent risk factors for GDM. Pregnant women might be screened for these risk factors at the first prenatal visit and considered for the high risk population for GDM.