Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria.
AIMS/INTRODUCTION
The International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria for gestational diabetes are associated with increased prevalence. However, it remains unknown if intervention for more women with gestational diabetes mellitus by the IADPSG criteria results in better pregnancy outcomes than adopting the Carpenter and Coustan (C&C) criteria in Asian populations.


MATERIALS AND METHODS
This was a retrospective cohort study. A total of 1,840 women, 952 subjects by the IADPSG criteria and 888 subjects by the C&C criteria, who delivered singletons in 2011 in a single tertiary center, were included in the study. The same therapeutic interventions were offered to women with gestational diabetes mellitus by the two criteria. Maternal and neonatal outcomes were evaluated.


RESULTS
Adopting the IADPSG criteria increased the prevalence of gestational diabetes mellitus diagnosis to 13.44%, compared with 2.59% by the C&C criteria. The diagnosis was made 3 weeks earlier by the IADPSG criteria (27 vs 30.5 weeks, P < 0.0001). Adopting the IADPSG criteria was associated with reduced risk of primary cesarean section (adjusted odds ratio 0.79, 95% confidence interval 0.63-0.998, P < 0.05) and having any one of the adverse fetal outcomes (adjusted odds ratio 0.79, 95% confidence interval 0.64-0.998, P < 0.05), including birthweight >90th percentile, jaundice, admission to neonatal intensive care unit, birth trauma, neonatal hypoglycemia and fetal death.


CONCLUSIONS
Adopting the IADPSG criteria is associated with improved pregnancy outcomes, at the expense of increased prevalence of gestational diabetes mellitus diagnosis.
['Wu|En-Tzu|ET|', 'Nien|Feng-Jung|FJ|', 'Kuo|Chun-Heng|CH|', 'Chen|Szu-Chi|SC|', 'Chen|Kuan-Yu|KY|', 'Chuang|Lee-Ming|LM|', 'Li|Hung-Yuan|HY|', 'Lee|Chien-Nan|CN|']
D000328:Adult D015331:Cohort Studies D003920:Diabetes Mellitus D016640:Diabetes, Gestational D005260:Female D006801:Humans D007231:Infant, Newborn D038622:Internationality D011247:Pregnancy D011256:Pregnancy Outcome D012189:Retrospective Studies
Gestational diabetes International Association of the Diabetes and Pregnancy Study Group criteria Carpenter and Coustan criteria