Gestational diabetes and pregnancy outcome – do we have right diagnostic criteria?

Abstract

OBJECTIVE: To determine thresholds of maternal glycemia at which specific adverse pregnancy outcomes occur in high-risk population. METHODS: A total of 1002 pregnant women with risk factors for gestational diabetes mellitus (GDM) underwent an originally modified glucose tolerance test (OGTT) with 75 g of glucose. Information on OGTT results and pregnancy outcomes were collected from database and medical records. RESULTS: Large for gestational age (LGA) newborn, infant's stay in the neonatal intensive care unit (NICU) >24 h, neonatal hyperbilirubinemia and cesarean section due to cephalopelvic disproportion were identified as specific GDM adverse outcomes. In the study group of participants with one or more specific GDM adverse outcomes, mean glycemic values during the modified OGTT (4.2 ± 1.0 mmol/L at 0 min, 6.8 ± 1.7 mmol/L at 30 min, 7.9 ± 2.1 mmol/L at 60 min, 7.7 ± 2.3 mmol/L at 90 min and 7.5 ± 2.3 mmol/L at 120 min) according to Student's t-test for independent samples were significantly higher than mean glycemic values in the control group of participants without specific adverse outcomes (p < 0.001, p = 0.02, p < 0.001, p < 0.001, p < 0.001). CONCLUSION: This study provides additional data that support the acceptance of the newly recommended outcome-based GDM diagnostic criteria.