A comparison of the International Association of Diabetes and Pregnancy Study Groups Recommendations with Former Criteria for Diagnosing Gestational Diabetes Mellitus: A Retrospective Cohort Study

Aim The aim of the study was to compare the frequency of gestational diabetes mellitus (GDM) and pregnancy outcomes in women diagnosed by WHO 1999 and IADPSG criteria. Methods This was a retrospective cohort study comprising 1508 women who underwent a 75-g OGTT after the 24th week of gestation at the University Hospital of Bialystok between 2004 and 2012. Results GDM was diagnosed by WHO 1999 criteria in 486 (32.2 %) patients and by IADPSG criteria in 397 (26.3 %) women. Three hundred fifty five (23.5%) patients fulfilled both criteria, whereas 111 (7.4 %) and 39 (2.6 %) subjects met only WHO 1999 or IADPSG criteria, respectively. Isolated fasting hyperglycemia was found in 3.4% of patients fulfilling WHO 1999 criteria and in 17.6 % of women who met IADPSG criteria. In total, fasting glycemic value was diagnostic in 42.8 % of the participants fulfilling the new criteria. The main risk factor for GDM was family history of diabetes (OR 2.285 [95 %CI: 1.772-2.945], p=0.00001). The rates of cesarean section and macrosomia were higher in the group with GDM than in the healthy women (54.7% vs 41.9% and 18.9 % vs 13.9 %, respectively), but the differences were not significant. Three months postpartum the disturbances of glucose tolerance were found in 21 % of the patients with GDM. Conclusions The introduction of the IADPS criteria did not increase the prevalence of GDM, but increased the number of patients with fasting hyperglycemia. Twelve weeks postpartum the patients with prior GDM had significantly higher post-load glucose levels than the healthy women.