The impact of implementing the WHO-2013 criteria for gestational diabetes mellitus on its prevalence and pregnancy outcomes: A comparison of the WHO-1999 and WHO-2013 diagnostic thresholds

Autor: Willy Visser, Madena Shareef, Langeza Saleh, Anton H. van den Meiracker
Přispěvatelé: Obstetrics & Gynecology, Internal Medicine
Rok vydání: 2020
Předmět:
Adult
Blood Glucose
medicine.medical_specialty
Adolescent
endocrine system diseases
Birth weight
World Health Organization
Fetal Macrosomia
Obesity
Maternal

Fasting glucose
Young Adult
03 medical and health sciences
0302 clinical medicine
SDG 3 - Good Health and Well-being
Pregnancy
Intensive Care Units
Neonatal

Prevalence
Birth Weight
Humans
Medicine
030212 general & internal medicine
Shoulder Dystocia
Oral glucose tolerance
Pregnancy outcomes
Netherlands
Retrospective Studies
Glycated Hemoglobin
030219 obstetrics & reproductive medicine
business.industry
Obstetrics
Infant
Newborn

nutritional and metabolic diseases
Obstetrics and Gynecology
Retrospective cohort study
Glucose Tolerance Test
Middle Aged
medicine.disease
Hypoglycemia
Gestational diabetes
Diabetes
Gestational

Reproductive Medicine
Premature Birth
Female
business
Body mass index
Zdroj: European Journal of Obstetrics, Gynecology and Reproductive Biology, 246, 14-18. Elsevier Ireland Ltd
ISSN: 0301-2115
DOI: 10.1016/j.ejogrb.2019.12.013
Popis: To determine the impact of implementing the new WHO-2013 criteria on prevalence of gestational diabetes mellitus (GDM) and pregnancy outcomes compared to the WHO-1999 criteria.A retrospective study conducted in pregnant women who were referred to the Erasmus MC for an oral glucose tolerance test (OGTT) between 2010 and 2015.Of 3089 women, 11.5 % (n = 354) were diagnosed with GDM based on the WHO-1999 criteria and 17.0 % (n = 524) based on the 2013-criteria, with 97 (3.1 %) reclassified as non-GDM and 267 (8.6 %) reclassified as GDM when shifting from the 1999 to 2013-criteria. In contrast to 60 % of patients in the WHO-2013 group, only 2 % of the WHO-1999 group was diagnosed with GDM because of an elevated fasting glucose only. Patients reclassified as GDM by WHO-2013 criteria had a higher body mass index (p 0.001) and delivered babies with a higher birth weight (p = 0.01). Maternal and neonatal adverse outcomes were comparable between patients with GDM based on WHO-1999 criteria and patients newly included by WHO-2013 criteria.Implementing the new diagnostic criteria leads to a considerable increase of prevalence of GDM. The newly included patients were more frequently overweighed and delivered babies with a higher birth weight. The added diagnostic value of the fasting glucose threshold of the WHO-1999 criteria is very low compared to the 2-h post-OGTT threshold, supporting the use of a lower fasting glucose threshold value as advocated by the WHO-2013 criteria.The new WHO-2013 criteria leads to a considerable increase of prevalence of GDM.
Databáze: OpenAIRE