scholarly journals Comparison of Birth Outcomes by Gestational Diabetes Screening Criteria

2018 ◽  
Vol 08 (04) ◽  
pp. e280-e288 ◽  
Author(s):  
Esa Davis ◽  
Christina Scifres ◽  
Kaleab Abebe ◽  
Tina Costacou ◽  
Diane Comer ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Birth Outcomes ◽  
International Association ◽  
Challenge Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Singleton Pregnancy ◽  
Screening Criteria ◽  
Iadpsg Criteria ◽  
Normal Glucose

Objectives This study is to examine the association between different diagnostic criteria for gestational diabetes mellitus (GDM) and adverse birth outcomes. Study Design A retrospective cohort study of 5,937 women with a singleton pregnancy was conducted, who completed GDM screening between 24 to 32 weeks gestational age. Four nonoverlapping groups of women defined as: 1) Normal: glucose challenge test (GCT) <130 mg/dL, 2) elevated GCT + normal oral glucose tolerance test (OGTT): abnormal 1 hour GCT + normal 3 hour OGTT, 3) GDM/International Association of Diabetes in Pregnancy Study Group (IADPSG): abnormal 3 hour OGTT by the IADPSG criteria, and 4) GDM/Carpenter-Coustan (CC): diagnosis per CC criteria. We used logistic regression to examine the association between GDM group classification and main outcome of macrosomia and secondary birth outcomes. Results Prevalences were GDM/CC 4.6%, GDM/IADPSG 3.0, and 7.6% overall. GDM/IADPSG group was associated with increased macrosomia (adj OR [odd ratio] 1.87; 95% CI [confidence interval]: 1.08–3.25; p = 0.02), while GDM/CC group was associated with increased preterm birth (adj OR 1.75; 95% CI: 1.05–2.80; p = 0.03). Conclusion Little difference in birth outcomes was found between the two criteria, GDM/CC and GDM/IADPSG. Randomized controlled trials are needed to clarify the risks and benefits of these screening paradigms before their incorporation into clinical practice.

Perinatal outcome in gestational diabetes according to different diagnostic criteria

2019 ◽  
Vol 47 (5) ◽  
pp. 553-557 ◽  
Author(s):  
Lina Salman ◽  
Anat Pardo ◽  
Eyal Krispin ◽  
Galia Oron ◽  
Yoel Toledano ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Challenge Test ◽  
Perinatal Outcomes ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Neonatal Hypoglycemia ◽  
Glucose Challenge ◽  
Nicu Admission

Abstract Objectives To evaluate whether gestational diabetes mellitus (GDM) diagnosed by different criteria impacts perinatal outcome. Methods This was a retrospective study of deliveries with a diagnosis of GDM (2014–2016). Perinatal outcomes were compared between patients with: (1) GDM diagnosed according to a single abnormal value on the 100-g oral glucose tolerance test (OGTT); (2) two or more abnormal OGTT values; and (3) a 50-g glucose challenge test (GCT) value ≥200 mg/dL. Results A total of 1163 women met the inclusion criteria, of whom 441 (37.9%) were diagnosed according to a single abnormal OGTT value, 627 (53.9%) had two or more abnormal OGTT values and 95 (8.17%) had a GCT value ≥200 mg/dL. Diet-only treatment was significantly higher in the single abnormal value group (70.3% vs. 65.1% vs. 50.5%) and rates of medical treatment were significantly higher in the GCT ≥ 200 mg/dL group (P < 0.05). Women in the GCT ≥ 200 mg/dL group had higher rates of neonatal intensive care unit (NICU) admission (10.5% vs. 2.7% vs. 2.8%, P < 0.001) and neonatal hypoglycemia (5.3% vs. 0.5% vs. 0.8%, P < 0.001). On multivariate logistic regression, GCT ≥ 200 mg/dL was no longer associated with higher rates of NICU admission and neonatal hypoglycemia (P > 0.05). Conclusion No difference was noted in the perinatal outcome amongst the different methods used for diagnosing GDM.

scholarly journals Incidence and Contributing Factors of Persistent Hyperglycemia at 6–12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Sedigheh Nouhjah ◽  
Hajieh Shahbazian ◽  
Nahid Shahbazian ◽  
Alireza Jahanshahi ◽  
Shayesteh Jahanfar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Glucose Intolerance ◽  
International Association ◽  
High Rate ◽  
Oral Glucose ◽  
Early Postpartum ◽  
Iadpsg Criteria

Background. A history of gestational diabetes is an important predictor of many metabolic disturbances later in life.Method. Life after gestational diabetes Ahvaz Study (LAGAs) is an ongoing population-based cohort study. Up to February 2016, 176 women with gestational diabetes underwent a 75 g oral glucose tolerance test (OGTT) at 6–12 weeks postpartum in Ahvaz (southwestern of Iran). Gestational diabetes was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and the American Diabetes Association (ADA) criteria applied for diagnosis of postpartum prediabetes and diabetes. Univariate and multivariate regression analysis were done.Results. Overall incidence of early postpartum glucose intolerance was 22.2% (95% CI, 16.3–29.0), 17.6% prediabetes (95% CI, 12.3–24.1) and 4.5% diabetes (95% CI, 2.0–8.8%). Independent risk factors for glucose intolerance were FPG ≥ 100 at the time of OGTT (OR 3.86; 95% CI; 1.60–9.32), earlier diagnosis of GDM (OR 0.92; 95% CI; 0.88–0.97), systolic blood pressure (OR 1.02; 95% CI; 1.002–1.04), and insulin or metformin therapy (OR 3.14; 95% CI; 1.20–8.21).Conclusion. Results determined a relatively high rate of glucose intolerance at 6–12 weeks after GDM pregnancy. Early postpartum screening of type 2 diabetes is needed particularly in women at high risk of type 2 diabetes.

scholarly journals Implementation of the International Association of Diabetes and Pregnancy Study Groups Criteria: Not Always a Cause for Concern

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Pooja Sibartie ◽  
Julie Quinlivan
Keyword(s):  
Diagnostic Criteria ◽  
International Association ◽  
Study Groups ◽  
Tolerance Test ◽  
Geographic Region ◽  
Oral Glucose ◽  
The North ◽  
Iadpsg Criteria ◽  
Before And After ◽  
Diabetes And Pregnancy

Background. Controversy surrounds the decision to adopt the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) as fears that disease prevalence rates will soar have been raised.Aims. To investigate the prevalence of pregnancy complicated with GDM before and after the introduction of the IADPSG 2010 diagnostic criteria.Materials and Methods. A prospective audit of all women who delivered from July 1, 2010, to June 30, 2014, in a predefined geographic region within the North Metropolitan Health Service of Western Australia. Women were diagnosed with GDM according to Australian Diabetes in Pregnancy Society (ADIPS 1991) criteria until December 31, 2011, and by the IADPSG 2010 criteria after this date. Incidence of GDM and predefined pregnancy outcomes were audited.Results. Of 10,296 women, antenatal oral glucose tolerance test (OGTT) results and follow-up data were obtained for 10,103 women (98%), of whom 349 (3.5%) were diagnosed with GDM. The rate of GDM utilising ADIPS criteria was 3.4% and the rate of utilising IADPSG criteria was 3.5% (p=0.92).Conclusion. IADPSG diagnostic criteria did not significantly increase the incidence of GDM in this low prevalence region.

scholarly journals Comparative analysis of current diagnostic criteria for gestational diabetes mellitus

2012 ◽  
Vol 5 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mariya V Boyadzhieva ◽  
Iliana Atanasova ◽  
Sabina Zacharieva ◽  
Tsvetalina Tankova ◽  
Violeta Dimitrova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
International Association ◽  
Study Groups ◽  
World Health ◽  
Oral Glucose ◽  
Significant Difference ◽  
Iadpsg Criteria

Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% ( P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.

scholarly journals The changing face of gestational diabetes: the effect of the shift from risk factor-based to comprehensive screening

2015 ◽  
Vol 173 (5) ◽  
pp. 623-632 ◽  
Author(s):  
Sanna Koivunen ◽  
Eero Kajantie ◽  
Annukka Torkki ◽  
Aini Bloigu ◽  
Mika Gissler ◽  
...  
Keyword(s):  
Risk Factor ◽  
Caesarean Section ◽  
Gestational Diabetes ◽  
Caesarean Section Rate ◽  
Tolerance Test ◽  
Population Based ◽  
Oral Glucose ◽  
Singleton Pregnancy ◽  
Medical Birth Register ◽  
Total Prevalence

ObjectiveTo evaluate the effect of the change in the gestational diabetes (GDM) screening policy from risk-factor based to comprehensive screening on the prevalence and type of GDM and characteristics of GDM pregnancies.DesignPopulation-based register study in Finland. Subjects were GDM women who gave birth before (2006,n=5185) and after (2010,n=6683) the policy change. All the other women in those years without pre-pregnancy diabetes acted as controls (51 759 and 52 398 respectively).MethodsGDM women with singleton pregnancy were identified through The Finnish Medical Birth Register by abnormal oral glucose tolerance test or initiation of insulin. Main outcome measures were prevalence of GDM (total and insulin/diet-treated), and caesarean section rate.ResultsThe proportion of screened mothers increased from 27.5 to 51.3% and the total prevalence of GDM from 9.1 to 11.3%. This increase consisted mainly of diet-treated mothers, while the number and proportion of insulin-treated mothers decreased (21.8% vs13.3%,P<0.001). The proportion of primiparous women increased (34.5–39.4%,P<0.0001) and mean pre-pregnancy BMI decreased (28.6–28.2,P<0.001). The overall caesarean section rate remained the same but increased among women with GDM (20.8–22.1%) adjusted odds ratios being 1.22 (95% CI 1.14, 1.31) during comprehensive and 1.10 (95% CI 1.02, 1.19) during risk factor-based screening.ConclusionsThe shift to comprehensive screening led to a significant increase in women with GDM, who were more often primiparous and had a lower BMI. Comprehensive screening did not perform better in diagnosing women needing insulin treatment.

scholarly journals Risk of gestational diabetes mellitus: which lifestyle parameters should be changed?

2017 ◽  
Vol 20 (1) ◽  
pp. 85-92
Author(s):  
Polina Viktorovna Popova ◽  
Aleksandra Sergeevna Tkachuk ◽  
Yana Alexeevna Bolotko ◽  
Andrey Sergeevich Gerasimov ◽  
Ksenia Alexandrovna Demidova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tolerance Test ◽  
Control Group ◽  
Oral Glucose ◽  
Food Groups ◽  
Dried Fruits ◽  
Iadpsg Criteria ◽  
Quantitative Manner

Background. Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It can cause significant problems for the mother and offspring, such as caesarean delivery, birth trauma and the development of type 2 diabetes mellitus (T2DM) in the future. The identification and correction of modifiable risk factors for GDM will provide a possibility to prevent these complications. Aim. This study aimed to identify the most significant lifestyle parameters affecting the risk of developing GDM. Methods. The study included 680 pregnant women who underwent oral glucose tolerance test at 2432 weeks of pregnancy and responded to a questionnaire comprising the following sections stratified in a semi-quantitative manner: the consumption of major food groups and drinks and the amount of physical activity and smoking before and during pregnancy. A logistic regression analysis was performed to identify lifestyle parameters that influence GDM development. GDM was diagnosed according to the IADPSG criteria. Results. GDM was diagnosed in 266 women; the other 414 women formed the control group. The most significant dietary risk factor for developing GDM was the consumption of sausage(s), dried fruits and fresh fruits. Eating sausage(s) more than thrice a week during pregnancy increased the risk of developing GDM by 2.4 times [95% confidence interval (CI), 1.53.8; p 0.001] and so did the consumption of dried fruits more than thrice a week during pregnancy [odds ratio (OR), 6.5; 95% CI, 2.516.8; p 0.001)] compared with the risk of GDM by less consumption of these food groups. A regular consumption of fresh fruits more than 12 times a week during pregnancy reduced the risk of GDM (OR, 0.5; 95% CI, 0.30.8; p = 0.015). The habit of climbing at least four floors per day during pregnancy also reduced the risk of GDM (OR, 0.7; 95% CI, 0.51.0; p = 0.069). Conclusions. The recommendations for GDM prevention should include limiting the consumption of sausage(s) and dried fruits, increasing the consumption of fresh fruits and introducing regular physical activities, such as climbing stairs.

scholarly journals ADCY5, CAPN10 and JAZF1 Gene Polymorphisms and Placental Expression in Women with Gestational Diabetes

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 806
Author(s):  
Przemysław Ustianowski ◽  
Damian Malinowski ◽  
Patrycja Kopytko ◽  
Michał Czerewaty ◽  
Maciej Tarnowski ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
International Association ◽  
Study Groups ◽  
Oral Glucose ◽  
Iadpsg Criteria ◽  
Capn10 Gene

Gestational diabetes mellitus (GDM) is carbohydrate intolerance that occurs during pregnancy. This disease may lead to various maternal and neonatal complications; therefore, early diagnosis is very important. Because of the similarity in pathogenesis of type 2 diabetes and GDM, the genetic variants associated with type 2 diabetes are commonly investigated in GDM. The aim of the present study was to examine the associations between the polymorphisms in the ADCY5 (rs11708067, rs2877716), CAPN10 (rs2975760, rs3792267), and JAZF1 (rs864745) genes and GDM as well as to determine the expression of these genes in the placenta. This study included 272 pregnant women with GDM and 348 pregnant women with normal glucose tolerance. The diagnosis of GDM was based on a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks gestation, according to International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. There were no statistically significant differences in the distribution of the ADCY5 gene (rs11708067, rs2877716) and CAPN10 gene (rs2975760, rs3792267) polymorphisms between pregnant women with normal carbohydrate tolerance and pregnant women with GDM. We have shown a lower frequency of JAZF1 gene rs864745 C allele carriers among women with GDM CC + CT vs. TT (OR = 0.60, 95% CI = 0.41–0.87, p = 0.006), and C vs. T (OR = 0.75, 95% CI = 0.60–0.95, p = 0.014). In addition, ADCY5 and JAZF1 gene expression was statistically significantly increased in the placentas of women with GDM compared with that of healthy women. The expression of the CAPN10 gene did not differ significantly between women with and without GDM. Our results indicate increased expression of JAZF1 and ADCY5 genes in the placentas of women with GDM as well as a protective effect of the C allele of the JAZF1 rs864745 gene polymorphism on the development of GDM in pregnant women.

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