Aminath Laafira1, Scott W White2,3,4, Christopher J Griffin4, Dorothy Graham1,2. 1. King Edward Memorial Hospital, Subiaco, Western Australia, Australia. 2. School of Women's and Infants' Health, The University of Western Australia, Subiaco, Western Australia, Australia. 3. Women and Infants Research Foundation, King Edward Memorial Hospital, Subiaco, Western Australia, Australia. 4. Maternal Fetal Medicine Service, King Edward Memorial Hospital, Subiaco, Western Australia, Australia.
Abstract
BACKGROUND: There is debate as to the most appropriate diagnostic criteria to diagnose gestational diabetes mellitus (GDM). The proposed International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria have recently been endorsed by various bodies, but there remains no national consensus. AIM: To assess the perinatal outcomes of women with GDM classified according to the 1998 Australasian Diabetes in Pregnancy Society (ADIPS) criteria compared to those with GDM by the IADPSG criteria. MATERIALS AND METHODS: Results of glucose tolerance tests performed between January 2011 and January 2014 were linked with the perinatal data of those who delivered singleton fetuses after 24 weeks' gestation. Analysed data included birthweight, gestational age at birth, macrosomia, mode of delivery, perinatal mortality, nursery admission, maternal body mass index, and gestational weight gain. RESULTS: Of 3571 women, 466 (13%) and 559 (16%) met the criteria for the 1998 ADIPS and IADPSG criteria for GDM, respectively. Those with GDM according to the IADPSG criteria only (6%) were more obese (95% CI 2.3-4.8 kg/m(2) ), delivered neonates on average 106 g heavier (95% CI 19-193 g) and had more fetal macrosomia (18% vs 11%, P = 0.002) than those with normal glucose tolerance. CONCLUSIONS: The IADPSG criteria for GDM identified a group of women at previously unrecognised increased risk of adverse perinatal outcomes. Adopting the IADPSG criteria would increase the number of women diagnosed with GDM by 20%; however, the improvements in perinatal morbidity, in addition to potential long-term benefits, may justify the increase in healthcare workload.
BACKGROUND: There is debate as to the most appropriate diagnostic criteria to diagnose gestational diabetes mellitus (GDM). The proposed International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria have recently been endorsed by various bodies, but there remains no national consensus. AIM: To assess the perinatal outcomes of women with GDM classified according to the 1998 Australasian Diabetes in Pregnancy Society (ADIPS) criteria compared to those with GDM by the IADPSG criteria. MATERIALS AND METHODS: Results of glucose tolerance tests performed between January 2011 and January 2014 were linked with the perinatal data of those who delivered singleton fetuses after 24 weeks' gestation. Analysed data included birthweight, gestational age at birth, macrosomia, mode of delivery, perinatal mortality, nursery admission, maternal body mass index, and gestational weight gain. RESULTS: Of 3571 women, 466 (13%) and 559 (16%) met the criteria for the 1998 ADIPS and IADPSG criteria for GDM, respectively. Those with GDM according to the IADPSG criteria only (6%) were more obese (95% CI 2.3-4.8 kg/m(2) ), delivered neonates on average 106 g heavier (95% CI 19-193 g) and had more fetal macrosomia (18% vs 11%, P = 0.002) than those with normal glucose tolerance. CONCLUSIONS: The IADPSG criteria for GDM identified a group of women at previously unrecognised increased risk of adverse perinatal outcomes. Adopting the IADPSG criteria would increase the number of women diagnosed with GDM by 20%; however, the improvements in perinatal morbidity, in addition to potential long-term benefits, may justify the increase in healthcare workload.
Authors: Sarah H Koning; Jelmer J van Zanden; Klaas Hoogenberg; Helen L Lutgers; Alberdina W Klomp; Fleurisca J Korteweg; Aren J van Loon; Bruce H R Wolffenbuttel; Paul P van den Berg Journal: Diabetologia Date: 2017-11-22 Impact factor: 10.122
Authors: Eva A R Goedegebure; Sarah H Koning; Klaas Hoogenberg; Fleurisca J Korteweg; Helen L Lutgers; Mattheus J M Diekman; Eva Stekkinger; Paul P van den Berg; Joost J Zwart Journal: BMC Pregnancy Childbirth Date: 2018-05-10 Impact factor: 3.007
Authors: Meena Bhatia; Lucy H Mackillop; Katy Bartlett; Lise Loerup; Yvonne Kenworthy; Jonathan C Levy; Andrew J Farmer; Carmelo Velardo; Lionel Tarassenko; Jane E Hirst Journal: J Clin Med Date: 2018-10-22 Impact factor: 4.241