Pregnancy outcomes according to the definition of gestational diabetes

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http://hdl.handle.net/10138/316188

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Koivunen , S , Viljakainen , M , Männistö , T , Gissler , M , Pouta , A , Kaaja , R , Eriksson , J , Laivuori , H , Kajantie , E & Vääräsmäki , M 2020 , ' Pregnancy outcomes according to the definition of gestational diabetes ' , PLoS One , vol. 15 , no. 3 , 0229496 . https://doi.org/10.1371/journal.pone.0229496

Title: Pregnancy outcomes according to the definition of gestational diabetes
Author: Koivunen, Sanna; Viljakainen, Matti; Männistö, Tuija; Gissler, Mika; Pouta, Anneli; Kaaja, Risto; Eriksson, Johan; Laivuori, Hannele; Kajantie, Eero; Vääräsmäki, Marja
Contributor: University of Helsinki, Clinicum
University of Helsinki, HUS Gynecology and Obstetrics
University of Helsinki, HUS Children and Adolescents
Date: 2020-03-05
Language: eng
Number of pages: 12
Belongs to series: PLoS One
ISSN: 1932-6203
URI: http://hdl.handle.net/10138/316188
Abstract: Objective To assess the frequency and perinatal outcomes of gestational diabetes mellitus (GDM) defined by the criteria according to the International Association of Diabetes in Pregnancy Study Group (IADPSG) and the National Institute for Health and Care Excellence (NICE) diagnostic criteria for GDM. Design A retrospective cohort study. Setting Six secondary and tertiary delivery hospitals in Finland in 2009. Population Pregnant women (N = 4,033) and their offspring. Methods We used data on comprehensive screening of pregnant women with a 2-h 75-g oral glucose tolerance test (OGTT), performed between gestational weeks 24 and 40. OGTT glucose concentrations were used to identify women who fulfilled IADPSG and NICE criteria. While cut-offs according to Finnish national criteria partly overlapped with both criteria, a subgroup of IADPSG- or NICE-positive GDM women remained undiagnosed by Finnish criteria and hence non-treated. They were analysed as subgroups and compared to controls who were negative with all cut-offs. Main outcome measures GDM prevalence, birth weight SD score (BWSDS), large for gestational age (LGA) and caesarean section (CS) rates. Results Among the 4,033 women screened for GDM, 1,249 (31.0%) and 529 (13.1%) had GDM according to the IADPSG and NICE criteria, respectively. The LGA rate was similar in both groups. Regardless of the diagnostic criteria, women with GDM had a higher risk of induced delivery and CSs than controls. In IADPSG-positive non-treated women, offspring’s BWSDS and CS rate were higher than in controls. Conclusions GDM prevalence was 2.4-fold higher according to the IADPSG compared with the NICE criteria but the LGA rate did not differ. BWSDS and CS rate were increased already with mild untreated hyperglycaemia.
Subject: 3121 Internal medicine
3123 Gynaecology and paediatrics
INTERNATIONAL ASSOCIATION
HYPERGLYCEMIA
MELLITUS
CLASSIFICATION
DIAGNOSIS
CRITERIA
QUALITY
RISK
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