Abstract:
Internationally accepted diagnostic criteria recommendations for gestational diabetes (GDM) in 2010 resulted in a rise in global prevalence of GDM. Our aim was to describe the trends in GDM before and after Icelandic guideline changes in 2012 and the trends in pregestational diabetes (PGDM). The study included all singleton births (N = 101 093) in Iceland during 1997-2020. Modified Poisson regression models were used to estimate prevalence ratios (PRs) with 95% confidence intervals (CIs) for risk of GDM overall and by maternal age group, as well as overall risk of PGDM, according to time period of birth. The overall prevalence of GDM by time period of birth ranged from 0.6% (N = 101) in 1997-2000 to 16.2% (N = 2720) in 2017-2020, and the prevalence of PGDM ranged from 0.4% (N = 57) in 1997-2000 to 0.7% (N = 120) in 2017-2020. The overall relative GDM prevalence rate difference before and after 2012 was 380%, and the largest difference was found among women aged <25 years at 473%. Risk of GDM increased in 2017-2020 (PR 14.21, CI 11.45, 17.64) compared to 1997-2000 and was highest among women aged >34 years with PR 19.46 (CI 12.36, 30.63) in 2017-2020. Prevalence rates of GDM and PGDM increased during the study period. An accelerated rate of increase in GDM was found after 2012, overall, and among all maternal age groups. Women aged >34 years had the greatest risk of GDM throughout all time periods, while women aged <25 years appear to have a higher relative rate difference after 2012.
摘要:
2010年国际公认的妊娠期糖尿病(GDM)诊断标准建议导致全球GDM患病率上升。我们的目的是描述2012年冰岛指南变更前后GDM的趋势以及孕前糖尿病(PGDM)的趋势。该研究包括1997-2020年冰岛的所有单胎分娩(N=1010093)。使用改良的Poisson回归模型来估计GDM总体和产妇年龄组的患病率比率(PR),95%置信区间(CI)。以及PGDM的总体风险,根据出生时间。按出生时间划分,GDM的总体患病率从1997-2000年的0.6%(N=101)到2017-2020年的16.2%(N=2720),PGDM的患病率从1997-2000年的0.4%(N=57)到2017-2020年的0.7%(N=120)。2012年前后GDM总体相对患病率差异为380%,最大的差异是年龄<25岁的女性,为473%。与1997-2000年相比,2017-2020年GDM的风险增加(PR14.21,CI11.45,17.64),在2017-2020年,年龄>34岁的女性中最高,PR19.46(CI12.36,30.63)。研究期间GDM和PGDM的患病率增加。总体上,2012年后发现GDM的增长速度加快,在所有产妇年龄组中。年龄>34岁的女性在所有时间段内患GDM的风险最大,而年龄<25岁的女性在2012年后似乎有更高的相对比率差异。