Relationship Between the IADPSG-criteria-defined Abnormal Glucose Values and Adverse Pregnancy Outcomes Among Women Having Gestational Diabetes Mellitus: A Retrospective Cohort Study

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Nov 10

PMID 30412096

Citations 12

Authors

Ting-Ting Ding

Jie Xiang

Bi-Ru Luo

Juan Hu

Affiliations

Soon will be listed here.

Abstract

To explore the influence of the 75 g oral glucose tolerance test (OGTT) on pregnancy outcomes and to determine the risk factors for adverse outcomes among women with gestational diabetes mellitus (GDM).This retrospective cohort study was conducted among women who had GDM and were treated between January 1, 2015 and December 31, 2017. The diagnostic criteria for GDM were proposed by the International Diabetes and Pregnancy Research Organization (IADPSG) in 2010. Women with GDM were stratified according to the number of abnormal OGTT values or the presence/absence of adverse pregnancy outcomes. Maternal characteristics, OGTT values, pregnancy outcomes, and the relationship between the latter 2 were analyzed.In total, 3221 pregnant women with GDM were included. The incidence of adverse outcomes was affected by maternal age (28-37 years, in particular; odds ratio [OR], 1.403; 95% confidence interval [CI], 1.037-1.899; P = .028), days of pregnancy (OR, 0.904; 95% CI, 0.894-0.914; P < .001), gestational weight gain (OR, 1.018; 95% CI, 1.000-1.036;, P = .048), and age of menarche (OR, 0.925; 95% CI, 0.863-0.992; P = .029). Both fasting plasma glucose (FPG) and 2-h OGTT were positively correlated with adverse outcomes, of which FPG was more predictive (FPG: OR, 1.143; 95% CI, 1.007-1.297; P = .038; 2-h OGTT: OR, 1.074; 95% CI, 1.018-1.133; P = .009). Meanwhile, higher abnormal OGTT values were associated with significantly increased risks of antenatal insulin treatment, cesarean delivery, premature delivery, gestational hypertension, premature rupture of membranes, preeclampsia, macrosomia, neonatal asphyxia, and full term low weight infants.OGTT values and the number of abnormal glucose are associated with various adverse pregnancy outcomes. Stratified management is recommended for pregnant women with GDM, especially those with fasting hyperglycemia and/or 3 abnormal OGTT values.

Citing Articles

Perinatal and neonatal outcomes in gestational diabetes: The importance of the number of abnormal values in an oral glucose tolerance test.

Etelainen S, Keikkala E, Lingaiah S, Viljakainen M, MaNnisto T, Pouta A Acta Obstet Gynecol Scand. 2024; 104(1):130-138.

PMID: 39473341 PMC: 11683557. DOI: 10.1111/aogs.14999.

Gestational diabetes complicated with preterm birth: a retrospective cohort study.

Huang S, Guo Y, Xu X, Jiang L, Yan J BMC Pregnancy Childbirth. 2024; 24(1):631.

PMID: 39354423 PMC: 11445954. DOI: 10.1186/s12884-024-06810-7.

Dietary Intake and Oral Glucose Tolerance Test Results in Women with Gestational Diabetes.

Chagas L, Torloni M, Silva-Neto L, Dualib P, de Sousa R, Bittencourt J J Clin Med. 2024; 13(10).

PMID: 38792489 PMC: 11122252. DOI: 10.3390/jcm13102948.

Refining the diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis.

Francis E, Powe C, Lowe Jr W, White S, Scholtens D, Yang J Commun Med (Lond). 2023; 3(1):185.

PMID: 38110524 PMC: 10728189. DOI: 10.1038/s43856-023-00393-8.

Prevalence of abnormal glucose values and gestational diabetes mellitus among pregnant women in Xi'an from 2015 to 2021.

Meng G, Wang Q, Kang R, Cheng X, Yang J, Xie Y BMC Pregnancy Childbirth. 2023; 23(1):471.

PMID: 37355571 PMC: 10290305. DOI: 10.1186/s12884-023-05798-w.

References

Basevi V, Di Mario S, Morciano C, Nonino F, Magrini N . Comment on: American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care 2011;34(Suppl. 1):S11-S61. Diabetes Care. 2011; 34(5):e53. PMC: 3114493. DOI: 10.2337/dc11-0174. View

Legardeur H, Girard G, Journy N, Ressencourt V, Durand-Zaleski I, Mandelbrot L . Factors predictive of macrosomia in pregnancies with a positive oral glucose challenge test: importance of fasting plasma glucose. Diabetes Metab. 2013; 40(1):43-48. DOI: 10.1016/j.diabet.2013.01.008. View

Ngala R, Fondjo L, Gmagna P, Ghartey F, Awe M . Placental peptides metabolism and maternal factors as predictors of risk of gestational diabetes in pregnant women. A case-control study. PLoS One. 2017; 12(7):e0181613. PMC: 5521813. DOI: 10.1371/journal.pone.0181613. View

Shi M, Liu Z, Steinmann P, Chen J, Chen C, Ma X . Medical nutrition therapy for pregnant women with gestational diabetes mellitus-A retrospective cohort study. Taiwan J Obstet Gynecol. 2016; 55(5):666-671. DOI: 10.1016/j.tjog.2016.01.005. View

Ikenoue S, Miyakoshi K, Saisho Y, Sakai K, Kasuga Y, Fukutake M . Clinical impact of women with gestational diabetes mellitus by the new consensus criteria: two year experience in a single institution in Japan. Endocr J. 2014; 61(4):353-8. DOI: 10.1507/endocrj.ej13-0496. View

Garrison E, Jagasia S . Inpatient management of women with gestational and pregestational diabetes in pregnancy. Curr Diab Rep. 2014; 14(2):457. DOI: 10.1007/s11892-013-0457-x. View

Sapienza A, Francisco R, Trindade T, Zugaib M . Factors predicting the need for insulin therapy in patients with gestational diabetes mellitus. Diabetes Res Clin Pract. 2010; 88(1):81-6. DOI: 10.1016/j.diabres.2009.12.023. View

Seghieri G, Tesi F, Anichini R, De Bellis A, Barsotti E, Mari A . Influence of gestational diabetes on the long-term control of glucose tolerance. Diabetologia. 2007; 50(11):2234-8. DOI: 10.1007/s00125-007-0802-1. View

Jensen D, Korsholm L, Ovesen P, Beck-Nielsen H, Molsted-Pedersen L, Damm P . Adverse pregnancy outcome in women with mild glucose intolerance: is there a clinically meaningful threshold value for glucose?. Acta Obstet Gynecol Scand. 2007; 87(1):59-62. DOI: 10.1080/00016340701823975. View

10.

Bakiner O, Bozkirli E, Ozsahin K, Sariturk C, Ertorer E . Risk Factors That can Predict Antenatal Insulin Need in Gestational Diabetes. J Clin Med Res. 2013; 5(5):381-8. PMC: 3748663. DOI: 10.4021/jocmr1515w. View

11.

Song Y, Yang H . [Clinical use of continuous glucose monitoring system in gestational diabetes mellitus and type 2 diabetes complicated with pregnancy]. Zhonghua Fu Chan Ke Za Zhi. 2014; 49(8):579-83. View

12.

Crowther C, Hiller J, Moss J, McPhee A, Jeffries W, Robinson J . Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005; 352(24):2477-86. DOI: 10.1056/NEJMoa042973. View

13.

Tieu J, McPhee A, Crowther C, Middleton P, Shepherd E . Screening for gestational diabetes mellitus based on different risk profiles and settings for improving maternal and infant health. Cochrane Database Syst Rev. 2017; 8:CD007222. PMC: 6483271. DOI: 10.1002/14651858.CD007222.pub4. View

14.

Metzger B, Lowe L, Dyer A, Trimble E, Chaovarindr U, Coustan D . Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358(19):1991-2002. DOI: 10.1056/NEJMoa0707943. View

15.

Lawlor D, Fraser A, Lindsay R, Ness A, Dabelea D, Catalano P . Association of existing diabetes, gestational diabetes and glycosuria in pregnancy with macrosomia and offspring body mass index, waist and fat mass in later childhood: findings from a prospective pregnancy cohort. Diabetologia. 2009; 53(1):89-97. DOI: 10.1007/s00125-009-1560-z. View

16.

Peng S, Zhang J, Liu L, Zhang X, Huang Q, Alamdar A . Newborn meconium and urinary metabolome response to maternal gestational diabetes mellitus: a preliminary case-control study. J Proteome Res. 2015; 14(4):1799-809. DOI: 10.1021/pr5011857. View

17.

Feng H, Zhu W, Yang H, Wei Y, Wang C, Su R . Relationship between Oral Glucose Tolerance Test Characteristics and Adverse Pregnancy Outcomes among Women with Gestational Diabetes Mellitus. Chin Med J (Engl). 2017; 130(9):1012-1018. PMC: 5421169. DOI: 10.4103/0366-6999.204928. View

18.

Wei Y, Yan J, Yang H . Identification of severe gestational diabetes mellitus after new criteria used in China. J Perinatol. 2015; 36(2):90-4. DOI: 10.1038/jp.2015.151. View

19.

Reichelt A, Weinert L, Mastella L, Gnielka V, Campos M, Hirakata V . Clinical characteristics of women with gestational diabetes - comparison of two cohorts enrolled 20 years apart in southern Brazil. Sao Paulo Med J. 2017; 135(4):376-382. PMC: 10015997. DOI: 10.1590/1516-3180.2016.0332190317. View

20.

Farrar D, Simmonds M, Bryant M, Lawlor D, Dunne F, Tuffnell D . Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts. PLoS One. 2017; 12(4):e0175288. PMC: 5383279. DOI: 10.1371/journal.pone.0175288. View