title: Potential impact of American Diabetes Association (2000) criteria for diagnosis of gestational diabetes mellitus in Spain.
abstract: OBJECTIVE
  This study was carried out to determine the impact of American Diabetes Association (ADA) 2000 criteria for the diagnosis of gestational diabetes mellitus (GDM) in the Spanish population.
  
  
  METHODS
  Pregnant women were assigned to one of four categories: negative screenees, false-positive screenees, ADA-only-GDM (untreated) and GDM according to National Diabetes Data Group (NDDG) criteria (treated). Fetal macrosomia and Caesarean section were defined as primary outcomes, with seven additional secondary outcomes.
  
  
  RESULTS
  Of 9,270 pregnant women screened for GDM, 819 (8.8%) met NDDG criteria. If the threshold for defining GDM had been lowered to ADA criteria, an additional 2.8% of women would have been defined as having the condition (relative increase of 31.8%). Maternal characteristics of women with ADA-only-GDM were between those of false-positive screenees and women with NDDG-GDM. The risk of diabetes-associated complications was slightly elevated in the individuals who would have been classified as abnormal only after the adoption of ADA criteria. In addition, the ADA-only-GDM contribution to morbidity was lower than that of other variables, especially BMI.
  
  
  CONCLUSIONS
  Use of the ADA criteria to identify GDM would result in a 31.8% increase in prevalence compared with NDDG criteria. However, as the contribution of these additionally diagnosed cases to adverse GDM outcomes is not substantial, a change in diagnostic criteria is not warranted in our setting.
authors.affiliation: Unit of Diabetes, Endocrinology and Nutrition, Hospital Universitari de Girona Doctor Josep Trueta, Avgda. de França s.n., 17007, Girona, Spain. uden.wricart@htrueta.scs.es
authors.forename: W
authors.initials: W
authors.lastname: Ricart
authors.forename: J
authors.initials: J
authors.lastname: López
authors.forename: J
authors.initials: J
authors.lastname: Mozas
authors.forename: A
authors.initials: A
authors.lastname: Pericot
authors.forename: M A
authors.initials: MA
authors.lastname: Sancho
authors.forename: N
authors.initials: N
authors.lastname: González
authors.forename: M
authors.initials: M
authors.lastname: Balsells
authors.forename: R
authors.initials: R
authors.lastname: Luna
authors.forename: A
authors.initials: A
authors.lastname: Cortázar
authors.forename: P
authors.initials: P
authors.lastname: Navarro
authors.forename: O
authors.initials: O
authors.lastname: Ramírez
authors.forename: B
authors.initials: B
authors.lastname: Flández
authors.forename: L F
authors.initials: LF
authors.lastname: Pallardo
authors.forename: A
authors.initials: A
authors.lastname: Hernández
authors.forename: J
authors.initials: J
authors.lastname: Ampudia
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Real
authors.forename: R
authors.initials: R
authors.lastname: Corcoy
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology*; D005189:False Positive Reactions; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012955:Societies, Medical; D013030:Spain / Q000453:epidemiology; D014481:United States