|Title:||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||Authors:||Wu E.-T.
|Issue Date:||2016||Publisher:||Blackwell Publishing||Journal Volume:||7||Journal Issue:||1||Start page/Pages:||121-126||Source:||Journal of Diabetes Investigation||Abstract:||
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. ? 2016 Asian Association for the Study of Diabetes and Wiley Publishing Asia Pty Ltd.
|ISSN:||2040-1116||DOI:||10.1111/jdi.12378||SDG/Keyword:||glucose; insulin; oral antidiabetic agent; adult; Article; Asian; birth weight; cesarean section; cohort analysis; controlled study; counseling; female; fetus death; fetus outcome; glucose blood level; hospital admission; human; hypoglycemia; jaundice; lifestyle modification; major clinical study; newborn intensive care; pregnancy diabetes mellitus; pregnancy outcome; priority journal; retrospective study; risk assessment; risk reduction; tertiary care center; comparative study; diabetes mellitus; Diabetes, Gestational; international cooperation; newborn; pregnancy; pregnancy outcome; Adult; Cohort Studies; Diabetes Mellitus; Diabetes, Gestational; Female; Humans; Infant, Newborn; Internationality; Pregnancy; Pregnancy Outcome; Retrospective Studies
|Appears in Collections:||醫學系|
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