Diabetes Metab J.  2019 Dec;43(6):766-775. 10.4093/dmj.2018.0192.

Pregnancy Outcomes of Women Additionally Diagnosed as Gestational Diabetes by the International Association of the Diabetes and Pregnancy Study Groups Criteria

• Kim MH
• Kwak SH
• Kim SH
• Hong JS
• Chung HR
• Choi SH
• Kim MY
• Jang HC

• KMID: 2466498
• DOI: http://doi.org/10.4093/dmj.2018.0192

Abstract

BACKGROUND
We investigated the pregnancy outcomes in women who were diagnosed with gestational diabetes mellitus (GDM) by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by the Carpenter-Coustan (CC) criteria.
METHODS
A total of 8,735 Korean pregnant women were identified at two hospitals between 2014 and 2016. Among them, 2,038 women participated in the prospective cohort to investigate pregnancy outcomes. Diagnosis of GDM was made via two-step approach with 50-g glucose challenge test for screening followed by diagnostic 2-hour 75-g oral glucose tolerance test. Women were divided into three groups: non-GDM, GDM diagnosed exclusively by the IADPSG criteria, and GDM diagnosed by the CC criteria.
RESULTS
The incidence of GDM was 2.1% according to the CC criteria, and 4.1% by the IADPSG criteria. Women diagnosed with GDM by the IADPSG criteria had a higher body mass index (22.0±3.1 kg/m² vs. 21.0±2.8 kg/m², P<0.001) and an increased risk of preeclampsia (odds ratio [OR], 6.90; 95% confidence interval [CI], 1.84 to 25.87; P=0.004) compared to non-GDM women. Compared to neonates of the non-GDM group, those of the IADPSG GDM group had an increased risk of being large for gestational age (OR, 2.39; 95% CI, 1.50 to 3.81; P<0.001), macrosomia (OR, 2.53; 95% CI, 1.26 to 5.10; P=0.009), and neonatal hypoglycemia (OR, 3.84; 95% CI, 1.01 to 14.74; P=0.049); they were also at an increased risk of requiring phototherapy (OR, 1.57; 95% CI, 1.07 to 2.31; P=0.022) compared to the non-GDM group.
CONCLUSION
The IADPSG criteria increased the incidence of GDM by nearly three-fold, and women diagnosed with GDM by the IADPSG criteria had an increased risk of adverse pregnancy outcomes in Korea.

Keyword

Diabetes, gestational; Glucose tolerance test; Infant, newborn; Pregnancy; Women

MeSH Terms

Body Mass Index
Cohort Studies
Diabetes, Gestational*
Diagnosis
Female
Gestational Age
Glucose
Glucose Tolerance Test
Humans
Hypoglycemia
Incidence
Infant, Newborn
Korea
Mass Screening
Phototherapy
Pre-Eclampsia
Pregnancy
Pregnancy Outcome*
Pregnancy*
Pregnant Women
Prospective Studies
Glucose

Figure

• 

  Fig. 1 Study scheme and number of participants in each group. GCT, glucose challenge test; OGTT, oral glucose tolerance test; GDM, gestational diabetes mellitus; IADPSG, International Association of the Diabetes and Pregnancy Study Groups; CC, Carpenter-Coustan. aGDM diagnosed exclusively by the IADPSG criteria, bGDM diagnosed by the CC criteria.

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