Carpenter-Coustan criteria compared with the national diabetes data group thresholds for gestational diabetes mellitus.
OBJECTIVE
To examine perinatal outcomes in women who would meet the diagnostic criteria for gestational diabetes mellitus (GDM) according to the Carpenter and Coustan but not by the National Diabetes Data Group (NDDG) thresholds.


METHODS
This is a retrospective cohort study of women screened for GDM between January 1988 and December 2001. During the study period, only women who were diagnosed with GDM by the NDDG criteria received counseling and treatment. Women diagnosed with GDM according to the Carpenter and Coustan thresholds but not by the NDDG criteria were compared with women without GDM by either criteria. Perinatal outcomes were examined using chi test and multivariable logistic regression analyses.


RESULTS
Among the 14,693 women screened for GDM, 753 (5.1%) would have GDM diagnosed by the Carpenter and Coustan criteria and 480 (3.3%) by the NDDG criteria only, giving 273 (1.9%) women as the study group. Compared with women without GDM, women with GDM by the Carpenter and Coustan but not by the NDDG criteria had higher odds of cesarean delivery (OR 1.44, 95% confidence interval [CI] 1.01-2.07), operative vaginal delivery (OR 1.72, 95% CI 1.20-2.46), birth weight greater than 4,500 g (OR 4.47, 95% CI 2.26-8.86), and shoulder dystocia (OR 2.24, 95% CI 1.03-4.88).


CONCLUSIONS
Women diagnosed with GDM by the Carpenter and Coustan criteria but not by the NDDG criteria had higher risk of operative deliveries, macrosomia, and shoulder dystocia. We recommend using the Carpenter and Coustan diagnostic thresholds for GDM, because these diagnostic criteria are more sensitive than the NDDG criteria.


METHODS
II.
Cheng
Yvonne W
YW
From the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California.
Block-Kurbisch
Ingrid
I
Caughey
Aaron B
AB
D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis*; D004420:Dystocia / Q000453:epidemiology; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012680:Sensitivity and Specificity