Yumei Wei1, Huixia Yang2, Weiwei Zhu1, Hongyun Yang3, Haixia Li3, Jie Yan1, Cuilin Zhang4. 1. Department of Obstetrics and Gynecology, Peking Univesity First Hospital, Beijing 100034, China. 2. Department of Obstetrics and Gynecology, Peking Univesity First Hospital, Beijing 100034, China. Email: yanghuixia@bjmu.edu.cn. 3. Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China. 4. Division of Epidemiology, Statistics, and Prevention Research NICHD/National Institutes of Health, 6100 Executive Blvd, Rm 7B03, Rockville, MD 20852, USA.
Abstract
BACKGROUND: The International Association of Diabetes and Pregnancy Study Group (IADPSG) recommended new diagnostic criteria for gestational diabetes mellitus (GDM) after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. METHODS: A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group (NDDG) or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. RESULTS: According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% (P < 0.01) respectively, and the prevalence of cesarean section (52.5% vs. 46.0%, P < 0.01), macrosomia (7.5% vs. 6.3%, P < 0.05), neonatal hypoglycemia (1.6% vs. 1.0%, P < 0.01), and perinatal death (0.5% vs. 0.2%, P < 0.01); the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section (62.3%) and macrosomia (14.8%) was the highest in untreated mild GDM patients. CONCLUSIONS: Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.
BACKGROUND: The International Association of Diabetes and Pregnancy Study Group (IADPSG) recommended new diagnostic criteria for gestational diabetes mellitus (GDM) after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. METHODS: A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group (NDDG) or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. RESULTS: According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% (P < 0.01) respectively, and the prevalence of cesarean section (52.5% vs. 46.0%, P < 0.01), macrosomia (7.5% vs. 6.3%, P < 0.05), neonatal hypoglycemia (1.6% vs. 1.0%, P < 0.01), and perinatal death (0.5% vs. 0.2%, P < 0.01); the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section (62.3%) and macrosomia (14.8%) was the highest in untreated mild GDM patients. CONCLUSIONS: Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.
Authors: Li Wen; Huisheng Ge; Juan Qiao; Lan Zhang; Xuyang Chen; Mark D Kilby; Ying Zhou; Jie Gan; Richard Saffery; Jianying Yan; Chao Tong; Hongbo Qi; Philip N Baker Journal: Nutr J Date: 2020-02-10 Impact factor: 3.271