title: Diagnostic criteria for gestational diabetes mellitus.
abstract: OBJECTIVE
  To answer two questions: is there a threshold for pathological hyperglycaemia after 24 weeks of gestation? What are the diagnostic criteria for gestational diabetes mellitus?
  
  
  METHODS
  Review of the literature considering the relationships between glucose values and complications during pregnancy in women without specific care for this condition. Only the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study meets sufficient quality criteria.
  
  
  RESULTS
  Increasing glucose values during pregnancy, either at fasting and after a 75-g oral glucose tolerance test, are independently associated according to a continuum with an increased risk of maternal-foetal complications, especially birth weight above the 90th percentile for gestational age, Caesarean delivery and foetal hyperinsulinemia. There is no obvious threshold at which risks increase. The International Association of Diabetes Pregnancy Study Group has proposed the following criteria, considering the glycemic values associated with a 1.75-fold increased risk of macrosomia, foetal hyperinsulinemia and adiposity in the HAPO study: fasting plasma glucose ≥ 0.92 g/L (5.1 mmol/L) and/or 1-hour plasma glucose value ≥ 1.80 g/L (10.0 mmol/L) and/or 2-hour plasma glucose value ≥ 1.53 g/L (8.5 mmol/L).
  
  
  CONCLUSIONS
  The choice of glycemic thresholds for defining gestational diabetes mellitus is necessarily arbitrary because of a continuum (NP2). Only experts may propose definition criteria.
authors.affiliation: AP-HP, Hôpital Jean Verdier, Service D'Encrinologie-Diabétologie-Nutrition Et Université Paris-Nord, CRNH-IdF, Avenue Du 14 Juillet, 93143 Bondy Cedex, France. emmanuel.cosson@jvr.aphp.fr
authors.forename: E
authors.initials: E
authors.lastname: Cosson
mesh_terms: D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods / Q000592:standards*