Tai-Ho Hung1, Fu-Ling Chu2, T'sang-T'ang Hsieh3. 1. Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: thh20@cgmh.org.tw. 2. Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan. 3. Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.
Abstract
OBJECTIVE: To compare the risk profiles for gestational diabetes mellitus (GDM) using a one-step and two-step screening method and diagnostic criteria. MATERIALS AND METHODS: A retrospective cohort study was conducted among women screened using Carpenter and Coustan's (C&C) criteria (two-step method) and the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria (one-step method). All deliveries after 28 weeks of gestation, except for pregnancies complicated by pre-pregnancy diabetes mellitus, were analyzed. Multiple logistic regression was used to assess the associations between GDM and various potential risk factors. RESULTS: Risk factors for C&C-defined GDM were pre-pregnancy body mass index >24.2 kg/m2 (adjusted odds ratio [OR] 2.49, 95% confidence interval [CI] 1.92-3.23), maternal age at delivery >34 years (adjusted OR 2.46, 95% CI 1.96-3.09), history of fetal death (adjusted OR 2.56, 95% CI 1.37-4.78), and chronic hypertension (adjusted OR 3.66, 95% CI 1.50-8.91). In addition to these factors, conception assisted by reproductive technology (adjusted OR 1.64, 95% CI 1.19-2.25) and genetic amniocentesis (adjusted OR 1.19, 95% CI 1.03-1.38) were IADPSG-defined GDM risk factors. CONCLUSION: Risk factors for GDM differ with the diagnostic criteria used. This information is important when changing GDM screening strategies from the two-step approach to the one-step approach.
OBJECTIVE: To compare the risk profiles for gestational diabetes mellitus (GDM) using a one-step and two-step screening method and diagnostic criteria. MATERIALS AND METHODS: A retrospective cohort study was conducted among women screened using Carpenter and Coustan's (C&C) criteria (two-step method) and the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria (one-step method). All deliveries after 28 weeks of gestation, except for pregnancies complicated by pre-pregnancy diabetes mellitus, were analyzed. Multiple logistic regression was used to assess the associations between GDM and various potential risk factors. RESULTS: Risk factors for C&C-defined GDM were pre-pregnancy body mass index >24.2 kg/m2 (adjusted odds ratio [OR] 2.49, 95% confidence interval [CI] 1.92-3.23), maternal age at delivery >34 years (adjusted OR 2.46, 95% CI 1.96-3.09), history of fetal death (adjusted OR 2.56, 95% CI 1.37-4.78), and chronic hypertension (adjusted OR 3.66, 95% CI 1.50-8.91). In addition to these factors, conception assisted by reproductive technology (adjusted OR 1.64, 95% CI 1.19-2.25) and genetic amniocentesis (adjusted OR 1.19, 95% CI 1.03-1.38) were IADPSG-defined GDM risk factors. CONCLUSION: Risk factors for GDM differ with the diagnostic criteria used. This information is important when changing GDM screening strategies from the two-step approach to the one-step approach.