PDF(Pubmed)
Abstract：
OBJECTIVE: The COVID-19 pandemic has necessitated less resource-intensive testing guidelines to identify gestational diabetes mellitus (GDM). We performed a scoping review of the international evidence reporting the ability of diagnostic tests recommended during the pandemic to accurately identify patients with GDM, compared to pre-pandemic reference standards, and associated test and clinical outcomes.
METHODS: A comprehensive search of the literature was carried out in Embase, LitCovid, Cochrane Covid-19 study register, and medRxiv on 14th June 2021.
RESULTS: 145 unique citations were returned; after screening according to pre-specified inclusion criteria by title and abstract and then full text, 13 studies involving 40,836 pregnant people and an additional 52,884 instances of OGTT were included. Thresholds defined in the Australian pandemic guideline appear adequate to identify most GDM cases; false negative cases appeared at lower risk of hyperglycaemia-in-pregnancy(HIP)-related events. For UK and Canadian guidelines, a larger proportion would be misdiagnosed as non-GDM; these false negative cases had broadly equivalent HIP-related event rates as true positives.
CONCLUSIONS: The OGTT remains the most effective test to identify abnormal glucose processing in pregnancy, supporting the prompt return to standard guidelines post-pandemic. Cohort studies investigating the impact of the change in guidelines on GDM pregnancies and associated outcomes are needed.
METHODS: A comprehensive search of the literature was carried out in Embase, LitCovid, Cochrane Covid-19 study register, and medRxiv on 14th June 2021.
RESULTS: 145 unique citations were returned; after screening according to pre-specified inclusion criteria by title and abstract and then full text, 13 studies involving 40,836 pregnant people and an additional 52,884 instances of OGTT were included. Thresholds defined in the Australian pandemic guideline appear adequate to identify most GDM cases; false negative cases appeared at lower risk of hyperglycaemia-in-pregnancy(HIP)-related events. For UK and Canadian guidelines, a larger proportion would be misdiagnosed as non-GDM; these false negative cases had broadly equivalent HIP-related event rates as true positives.
CONCLUSIONS: The OGTT remains the most effective test to identify abnormal glucose processing in pregnancy, supporting the prompt return to standard guidelines post-pandemic. Cohort studies investigating the impact of the change in guidelines on GDM pregnancies and associated outcomes are needed.
摘要：
目的：COVID-19大流行需要较少的资源密集型检测指南来识别妊娠期糖尿病（GDM）。我们对报告大流行期间推荐的诊断测试的能力的国际证据进行了范围审查，以准确识别GDM患者，与大流行前参考标准相比，以及相关的测试和临床结果。
方法：在Embase中对文献进行了全面搜索，LitCovid,CochraneCovid-19研究登记册，和medRxiv在2021年6月14日。
结果：返回了145个独特的引文；在根据标题和摘要然后全文根据预先指定的纳入标准进行筛选后，包括13项研究，涉及40,836名孕妇和另外52,884例OGTT。澳大利亚大流行指南中定义的阈值似乎足以识别大多数GDM病例；假阴性病例出现的妊娠高血糖症（HIP）相关事件的风险较低。对于英国和加拿大的指导方针，更大的比例会被误诊为非GDM;这些假阴性病例的HIP相关事件发生率与真阳性大致相当.
结论：OGTT仍然是确定妊娠期葡萄糖处理异常的最有效测试，支持在大流行后迅速恢复标准准则。需要进行队列研究，调查指南更改对GDM妊娠和相关结局的影响。
方法：在Embase中对文献进行了全面搜索，LitCovid,CochraneCovid-19研究登记册，和medRxiv在2021年6月14日。
结果：返回了145个独特的引文；在根据标题和摘要然后全文根据预先指定的纳入标准进行筛选后，包括13项研究，涉及40,836名孕妇和另外52,884例OGTT。澳大利亚大流行指南中定义的阈值似乎足以识别大多数GDM病例；假阴性病例出现的妊娠高血糖症（HIP）相关事件的风险较低。对于英国和加拿大的指导方针，更大的比例会被误诊为非GDM;这些假阴性病例的HIP相关事件发生率与真阳性大致相当.
结论：OGTT仍然是确定妊娠期葡萄糖处理异常的最有效测试，支持在大流行后迅速恢复标准准则。需要进行队列研究，调查指南更改对GDM妊娠和相关结局的影响。
