Evaluation of guidelines on the screening and diagnosis of gestational diabetes mellitus: systematic review

BMJ Open - Tập 9 Số 5 - Trang e023014 - 2019
Lizhen Liao1,2, Yun Xu3, Xiaodong Zhuang4, Hong Shu-bin5, Zilian Wang6, Dobs Adrian Sandra7, Bin Liu6
1Department of Health, Guangdong Pharmaceutical University, Guangzhou, China
2Guangdong Engineering Research Center for Light and Health, Guangdong Pharmaceutical University, Guangzhou, China
3Department of Endocrinology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
4Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
5Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
6Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
7Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA

Tóm tắt

ObjectiveGuidelines for screening and diagnosis of gestational diabetes mellitus (GDM) have been updated in the past several years, and various inconsistencies exist across these guidelines. Moreover, the quality of these updated guidelines has not been clarified. We thus conducted this systematic review to evaluate the relationship between the quality and detailed recommendations of these guidelines.Data sourcesThe Guidelines International Network Library, the National Institute for Health and Clinical Excellence (NICE) database, the Medline database, the Embase and the National Guidelines Clearinghouse were searched for guidelines containing recommendations on screening and diagnosis strategies for GDM between 2009 and November 2018.MethodsGuidelines included a target group of women with GDM, and contained recommendations for screening and diagnostic strategies for GDM were included in the present systematic review. Reviewers summarised recommendations on screening and diagnosis strategies from each guideline and rated the quality of guidelines by using the Appraisal of Guidelines Research and Evaluation (AGREE) criteria.ResultsA total of 459 citations were collected by the preliminary literature selection, and 16 guidelines that met the inclusion criteria were assessed. The inconsistencies of the guidelines mainly focus on the screening process (one step vs two step) and criteria of oral glucose tolerance test (OGTT) (International Association of Diabetes and Pregnancy Study Groups [IADPSG] vs CarpenterandCoustan). Guidelines with higher AGREE scores usually recommend a one-step OGTT strategy with IADPSG criteria between 24 and 28 gestational weeks, and the majority of these guidelines likely to select evidence by Grading of Recommendations Assessment, Development and Evaluation criteria.ConclusionsThe guidelines of WHO-2013, NICE-2015, American Diabetes Association-2018, Endocrine Society-2013, Society of Obstetricians and Gynaecologists of Canada-2016, International Federation of Gynecology and Obstetrics-2015, American College of Obstetricians and Gynecologists-2018, United States Preventive Services Task Force-2014 and IADPSG-2015 are strongly recommended in the present evaluation, according to the AGREE II criteria. Guidelines with higher quality tend to recommend a one-step 75 g OGTT strategy with IADPSG criteria between 24 and 28 gestational weeks.

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BMJ Open

Tập 9 Số 5

e023014

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