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CC BY-NC-ND 4.0 · AJP Rep 2018; 08(04): e280-e288
DOI: 10.1055/s-0038-1675343
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comparison of Birth Outcomes by Gestational Diabetes Screening Criteria

Esa M. Davis
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Christina M. Scifres
2   Department of Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, Oklahoma
,
Kaleab Abebe
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Tina Costacou
3   Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Diane Comer
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Patrick Catalano
4   Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, Ohio
,
Hyagriv Simhan
5   Division Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Matthew Freiberg
6   Department of Medicine, Vanderbilt University, Nashville, Tennessee
,
Nancy Day
7   Department of Epidemiology and Psychiatry, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
› Author Affiliations Funding The project was supported by the University of Pittsburgh CTSI from the National Institutes of Health through Grant Numbers UL1 RR024153 and UL1TR000005 and by funding from the AHRQ K12 CER grant number 1K 12HS019461 01.
Further Information

Publication History

22 February 2018

05 September 2018

Publication Date:
29 October 2018 (online)

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Abstract

Objectives This study is to examine the association between different diagnostic criteria for gestational diabetes mellitus (GDM) and adverse birth outcomes.

Study Design A retrospective cohort study of 5,937 women with a singleton pregnancy was conducted, who completed GDM screening between 24 to 32 weeks gestational age. Four nonoverlapping groups of women defined as: 1) Normal: glucose challenge test (GCT) <130 mg/dL, 2) elevated GCT + normal oral glucose tolerance test (OGTT): abnormal 1 hour GCT + normal 3 hour OGTT, 3) GDM/International Association of Diabetes in Pregnancy Study Group (IADPSG): abnormal 3 hour OGTT by the IADPSG criteria, and 4) GDM/Carpenter-Coustan (CC): diagnosis per CC criteria. We used logistic regression to examine the association between GDM group classification and main outcome of macrosomia and secondary birth outcomes.

Results Prevalences were GDM/CC 4.6%, GDM/IADPSG 3.0, and 7.6% overall. GDM/IADPSG group was associated with increased macrosomia (adj OR [odd ratio] 1.87; 95% CI [confidence interval]: 1.08–3.25; p = 0.02), while GDM/CC group was associated with increased preterm birth (adj OR 1.75; 95% CI: 1.05–2.80; p = 0.03).

Conclusion Little difference in birth outcomes was found between the two criteria, GDM/CC and GDM/IADPSG. Randomized controlled trials are needed to clarify the risks and benefits of these screening paradigms before their incorporation into clinical practice.

Keywords

screening strategies - gestational diabetes - fetal growth - pregnancy outcomes
 

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