Diagnosis of XXXX : falling through the net.

@entity1 @entity2978 @entity4837 @entity6 @entity1266 @entity204 @entity413
AIMS/HYPOTHESIS: @entity6 ( @entity6 ) is associated with increased risks to mother and @entity1 , but globally agreed diagnostic criteria remain elusive. Identification of @entity1 with @entity6 is important, as treatment reduces adverse outcomes such as perinatal @entity204 , shoulder @entity1266 and @entity4837 . Recently, the UK's National Institute for Health and Care Excellence (NICE) recommended new diagnostic thresholds for @entity6 which are different from the International Association of the @entity6 Study Groups (IADPSG) criteria endorsed by the WHO. The study aim was to assess neonatal and obstetric outcomes among @entity1 who would test positive for the IADPSG criteria but negative for the NICE 2015 criteria. METHODS: Data from 25,543 consecutive singleton live births (2004-2008) were obtained retrospectively from hospital records. @entity1 were screened with a random plasma @entity413 (RPG; 12-16  weeks) and a 50  g @entity413 challenge test (GCT; 26-28  weeks). If RPG >7.0  mmol/l, GCT >7.7  mmol/l or symptoms were present, a 75  g OGTT was offered (n   =   3,848). RESULTS: In this study, @entity6 prevalence was 4.13% (NICE 2015) and 4.62% (IADPSG). @entity1 who 'fell through the net', testing NICE-negative but IADPSG-positive (n   =   387), had a higher risk of having a large-for-gestational-age (LGA) @entity1 (birthweight >90th percentile for gestational age; adjusted OR [95% CI] 3.12 [2.44, 3.98]), Caesarean delivery (1.44 [1.15, 1.81]) and @entity2978 (6.90 [3.94, 12.08]) compared with @entity1 with negative screening results and no OGTT (n   =   21,695). LGA risk was highest among @entity1 with fasting plasma @entity413 5.1-5.5  mmol/l (n   =   167): the mean birthweight was 350  g above that of the reference population and 37.7% of @entity1 were LGA. CONCLUSIONS/INTERPRETATION: The IADPSG criteria identify @entity1 at substantial risk of complications who would not be identified by the NICE 2015 criteria.
