AIM: To compare the pregnancy outcome of patients diagnosed with gestational diabetes mellitus (GDM) using the Carpenter-Coustan (CC) criteria with that of non-GDM pregnant women at Siriraj Hospital, Bangkok. METHODS: A retrospective study was carried out by reviewing medical records of pregnant women who underwent 100-g oral glucose tolerance test (OGTT) for diagnosing GDM between January 2009 and December 2012 at Siriraj Hospital. Pregnant women were divided into three groups according to the 100-g OGTT result: group 1, pregnant women with normal OGTT on both CC and National Diabetes Data Group (NDDG) criteria; group 2, pregnant women with normal OGTT on NDDG criteria but GDM on CC criteria; and group 3, pregnant women with GDM on CC criteria after December 2012 and enrolled in glycemic control program. Maternal and perinatal outcomes were compared between the groups. RESULTS: During the study period, the incidence of GDM increased 32.76% using the CC criteria. These women (group 2) had a higher risk of neonatal hypoglycemia (6.7% vs 0.6%; OR, 12.3; P < 0.0001), neonatal hyperbilirubinemia (13.7% vs 7.8%; OR, 1.9; P = 0.013) compared with group 1. Pregnant women in group 3 had a lower incidence of immediate post-partum hemorrhage from vaginal delivery than group 2 (0 vs 2.9%; P = 0.04) as well as lower rates of neonatal hypoglycemia and neonatal hyperbilirubinemia. CONCLUSION: Use of CC criteria increases the prevalence of GDM, but managing these women according to the program for GDM can improve the adverse neonatal outcome.
AIM: To compare the pregnancy outcome of patients diagnosed with gestational diabetes mellitus (GDM) using the Carpenter-Coustan (CC) criteria with that of non-GDM pregnant women at Siriraj Hospital, Bangkok. METHODS: A retrospective study was carried out by reviewing medical records of pregnant women who underwent 100-g oral glucose tolerance test (OGTT) for diagnosing GDM between January 2009 and December 2012 at Siriraj Hospital. Pregnant women were divided into three groups according to the 100-g OGTT result: group 1, pregnant women with normal OGTT on both CC and National Diabetes Data Group (NDDG) criteria; group 2, pregnant women with normal OGTT on NDDG criteria but GDM on CC criteria; and group 3, pregnant women with GDM on CC criteria after December 2012 and enrolled in glycemic control program. Maternal and perinatal outcomes were compared between the groups. RESULTS: During the study period, the incidence of GDM increased 32.76% using the CC criteria. These women (group 2) had a higher risk of neonatal hypoglycemia (6.7% vs 0.6%; OR, 12.3; P < 0.0001), neonatal hyperbilirubinemia (13.7% vs 7.8%; OR, 1.9; P = 0.013) compared with group 1. Pregnant women in group 3 had a lower incidence of immediate post-partum hemorrhage from vaginal delivery than group 2 (0 vs 2.9%; P = 0.04) as well as lower rates of neonatal hypoglycemia and neonatal hyperbilirubinemia. CONCLUSION: Use of CC criteria increases the prevalence of GDM, but managing these women according to the program for GDM can improve the adverse neonatal outcome.
Authors: Thubasni Kunasegaran; Vinod R M T Balasubramaniam; Valliammai Jayanthi Thirunavuk Arasoo; Uma Devi Palanisamy; Amutha Ramadas Journal: Int J Environ Res Public Health Date: 2021-01-31 Impact factor: 3.390