International Association of Diabetes and Pregnancy Study Group criteria is suitable for gestational diabetes mellitus diagnosis： further evidence from China

• Published in: Chinese medical journal Vol. 127; no. 20; pp. 3553 - 3556
• Main Authors: Wei, Yumei, Yang, Huixia, Zhu, Weiwei, Yang, Hongyun, Li, Haixia, Yan, Jie, Zhang, Cuilin
• Format: Journal Article
• Language: English
• Published: China Department of Obstetrics and Gynecology, Peking Univesity First Hospital, Beijing 100034, China%Department of Clinical Laboratory, Peking University First Hospital,Beijing 100034, China%Division of Epidemiology, Statistics, and Prevention Research NICHD/National Institutes of Health, 6100 Executive Blvd, Rm 7B03, Rockville, MD 20852, USA 2014
• Subjects: China - epidemiology; Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Female; Humans; Hyperglycemia - diagnosis; Hyperglycemia - epidemiology; Infant, Newborn; Pregnancy; Prospective Studies; 中国内地; 北京大学第一医院; 妊娠期; 妊娠高血压综合征; 标准协会; 糖尿病; 证据; 诊断; China; cesarean section; gestational diabetes mellitus; macrosomia; neonatal hypoglycemia
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.20140898

Background The International Association of Diabetes and Pregnancy Study Group （IADPSG） recommended new diagnostic criteria for gestational diabetes mellitus （GDM） after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes （HAPO） study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. Methods A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group （NDDG） or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. Results According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% （P 〈0.01） respectively, and the prevalence of cesarean section （52.5% vs. 46.0%, P 〈0.01）, macrosomia （7.5% vs. 6.3%, P 〈0.05）, neonatal hypoglycemia （1.6% vs. 1.0%, P 〈0.01）, and perinatal death （0.5% vs. 0.2%, P 〈0.01）; the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section （62.3%） and macrosomia （14.8%） was the highest in untreated mild GDM patients. Conclusions Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.