The World Health Organization (WHO) versus the International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria of gestational diabetes mellitus (GDM) and their associated maternal and neonatal outcomes

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Abstract

Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. The aim of this study was to compare the prevalence of GDM using the World Health Organization (WHO) criteria and the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in our population. We further compared the incidence of adverse maternal and neonatal outcomes in women diagnosed with GDM using these criteria and determined whether the IADPSG criteria is suitable in our population. This randomized controlled trial was conducted at our antenatal clinic involving 520 patients from 1st February 2015 until 30th September 2017. They were randomized into the WHO and the IADPSG groups. All eligible women underwent a standard oral glucose tolerance test with 75 g glucose, their fasting and 2 h post prandial glucose levels were taken. The primary outcome was the prevalence of GDM. The secondary outcomes were the incidence of primary cesarean section, gestational hypertension or preeclampsia, preterm delivery <37 weeks, fetal macrosomia, neonatal hypoglycemia and shoulder dystocia or birth injury. The prevalence of GDM in both groups were similar (37.9% vs. 38.6%). GDM women in the WHO group had a significantly higher incidence of gestational hypertension or preeclampsia (p = 0.004) and neonatal hypoglycemia (p = 0.042). In contrast, GDM women in the IADPSG group had a significantly higher incidence of fetal macrosomia (p = 0.027) and cesarean section (p = 0.012). The IADPSG diagnostic criteria for GDM may not be suitable for use in our population as it resulted in women being diagnosed later and being undertreated, thus leading to adverse maternal and neonatal outcomes.

Original languageEnglish
Article number20170077
JournalUnknown Journal
DOIs
Publication statusAccepted/In press - 17 Feb 2018

Fingerprint

Gestational Diabetes
diabetes
World Health Organization
Medical problems
pregnancy
Mothers
Health
Pregnancy
Fetal Macrosomia
Pregnancy Induced Hypertension
Incidence
Pre-Eclampsia
Hypoglycemia
Cesarean Section
Glucose
hypertension
glucose
Birth Injuries
Population
Dystocia

Keywords

  • gestational diabetes mellitus
  • IADPSG
  • WHO

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Molecular Biology
  • Endocrinology

Cite this

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title = "The World Health Organization (WHO) versus the International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria of gestational diabetes mellitus (GDM) and their associated maternal and neonatal outcomes",
abstract = "Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. The aim of this study was to compare the prevalence of GDM using the World Health Organization (WHO) criteria and the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in our population. We further compared the incidence of adverse maternal and neonatal outcomes in women diagnosed with GDM using these criteria and determined whether the IADPSG criteria is suitable in our population. This randomized controlled trial was conducted at our antenatal clinic involving 520 patients from 1st February 2015 until 30th September 2017. They were randomized into the WHO and the IADPSG groups. All eligible women underwent a standard oral glucose tolerance test with 75 g glucose, their fasting and 2 h post prandial glucose levels were taken. The primary outcome was the prevalence of GDM. The secondary outcomes were the incidence of primary cesarean section, gestational hypertension or preeclampsia, preterm delivery <37 weeks, fetal macrosomia, neonatal hypoglycemia and shoulder dystocia or birth injury. The prevalence of GDM in both groups were similar (37.9{\%} vs. 38.6{\%}). GDM women in the WHO group had a significantly higher incidence of gestational hypertension or preeclampsia (p = 0.004) and neonatal hypoglycemia (p = 0.042). In contrast, GDM women in the IADPSG group had a significantly higher incidence of fetal macrosomia (p = 0.027) and cesarean section (p = 0.012). The IADPSG diagnostic criteria for GDM may not be suitable for use in our population as it resulted in women being diagnosed later and being undertreated, thus leading to adverse maternal and neonatal outcomes.",
keywords = "gestational diabetes mellitus, IADPSG, WHO",
author = "Basri, {Nurul Iftida} and {Abdullah Mahdy}, Zaleha and Shuhaila Ahmad and {Abdul Karim}, {Abdul Kadir} and Lim, {Pei Shan} and {Abdul Manaf}, {Mohd Rizal} and {Mohamed Ismail}, {Nor Azlin}",
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T1 - The World Health Organization (WHO) versus the International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria of gestational diabetes mellitus (GDM) and their associated maternal and neonatal outcomes

AU - Basri, Nurul Iftida

AU - Abdullah Mahdy, Zaleha

AU - Ahmad, Shuhaila

AU - Abdul Karim, Abdul Kadir

AU - Lim, Pei Shan

AU - Abdul Manaf, Mohd Rizal

AU - Mohamed Ismail, Nor Azlin

PY - 2018/2/17

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N2 - Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. The aim of this study was to compare the prevalence of GDM using the World Health Organization (WHO) criteria and the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in our population. We further compared the incidence of adverse maternal and neonatal outcomes in women diagnosed with GDM using these criteria and determined whether the IADPSG criteria is suitable in our population. This randomized controlled trial was conducted at our antenatal clinic involving 520 patients from 1st February 2015 until 30th September 2017. They were randomized into the WHO and the IADPSG groups. All eligible women underwent a standard oral glucose tolerance test with 75 g glucose, their fasting and 2 h post prandial glucose levels were taken. The primary outcome was the prevalence of GDM. The secondary outcomes were the incidence of primary cesarean section, gestational hypertension or preeclampsia, preterm delivery <37 weeks, fetal macrosomia, neonatal hypoglycemia and shoulder dystocia or birth injury. The prevalence of GDM in both groups were similar (37.9% vs. 38.6%). GDM women in the WHO group had a significantly higher incidence of gestational hypertension or preeclampsia (p = 0.004) and neonatal hypoglycemia (p = 0.042). In contrast, GDM women in the IADPSG group had a significantly higher incidence of fetal macrosomia (p = 0.027) and cesarean section (p = 0.012). The IADPSG diagnostic criteria for GDM may not be suitable for use in our population as it resulted in women being diagnosed later and being undertreated, thus leading to adverse maternal and neonatal outcomes.

AB - Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. The aim of this study was to compare the prevalence of GDM using the World Health Organization (WHO) criteria and the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in our population. We further compared the incidence of adverse maternal and neonatal outcomes in women diagnosed with GDM using these criteria and determined whether the IADPSG criteria is suitable in our population. This randomized controlled trial was conducted at our antenatal clinic involving 520 patients from 1st February 2015 until 30th September 2017. They were randomized into the WHO and the IADPSG groups. All eligible women underwent a standard oral glucose tolerance test with 75 g glucose, their fasting and 2 h post prandial glucose levels were taken. The primary outcome was the prevalence of GDM. The secondary outcomes were the incidence of primary cesarean section, gestational hypertension or preeclampsia, preterm delivery <37 weeks, fetal macrosomia, neonatal hypoglycemia and shoulder dystocia or birth injury. The prevalence of GDM in both groups were similar (37.9% vs. 38.6%). GDM women in the WHO group had a significantly higher incidence of gestational hypertension or preeclampsia (p = 0.004) and neonatal hypoglycemia (p = 0.042). In contrast, GDM women in the IADPSG group had a significantly higher incidence of fetal macrosomia (p = 0.027) and cesarean section (p = 0.012). The IADPSG diagnostic criteria for GDM may not be suitable for use in our population as it resulted in women being diagnosed later and being undertreated, thus leading to adverse maternal and neonatal outcomes.

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