title: Impact of ethnicity on gestational diabetes identified with the WHO and the modified International Association of Diabetes and Pregnancy Study Groups criteria: a population-based cohort study.
abstract: OBJECTIVE
  The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recently proposed new criteria for diagnosing gestational diabetes mellitus (GDM). We compared prevalence rates, risk factors, and the effect of ethnicity using the World Health Organization (WHO) and modified IADPSG criteria.
  
  
  METHODS
  This was a population-based cohort study of 823 (74% of eligible) healthy pregnant women, of whom 59% were from ethnic minorities. Universal screening was performed at 28±2 weeks of gestation with the 75 g oral glucose tolerance test (OGTT). Venous plasma glucose (PG) was measured on site. GDM was diagnosed as per the definition of WHO criteria as fasting PG (FPG) ≥7.0 or 2-h PG ≥7.8 mmol/l; and as per the modified IADPSG criteria as FPG ≥5.1 or 2-h PG ≥8.5 mmol/l.
  
  
  RESULTS
  OGTT was performed in 759 women. Crude GDM prevalence was 13.0% with WHO (Western Europeans 11%, ethnic minorities 15%, P=0.14) and 31.5% with modified IADPSG criteria (Western Europeans 24%, ethnic minorities 37%, P< 0.001). Using the WHO criteria, ethnic minority origin was an independent predictor (South Asians, odds ratio (OR) 2.24 (95% confidence interval (CI) 1.26-3.97); Middle Easterners, OR 2.13 (1.12-4.08)) after adjustments for age, parity, and prepregnant body mass index (BMI). This increased OR was unapparent after further adjustments for body height (proxy for early life socioeconomic status), education and family history of diabetes. Using the modified IADPSG criteria, prepregnant BMI (1.09 (1.05-1.13)) and ethnic minority origin (South Asians, 2.54 (1.56-4.13)) were independent predictors, while education, body height and family history had little impact.
  
  
  CONCLUSIONS
  GDM prevalence was overall 2.4-times higher with the modified IADPSG criteria compared with the WHO criteria. The new criteria identified many subjects with a relatively mild increase in FPG, strongly associated with South Asian origin and prepregnant overweight.
authors: Department of Endocrinology, Oslo University Hospital HF, Aker, PO Box 4959 Nydalen, N-0424 Oslo, Norway. a.k.jenum@medisin.uio.no
authors: Anne K
authors: AK
authors: Jenum
authors: Kjersti
authors: K
authors: Mørkrid
authors: Line
authors: L
authors: Sletner
authors: Siri
authors: S
authors: Vangen
authors: Siri
authors: S
authors: Vange
authors: Johan L
authors: JL
authors: Torper
authors: Britt
authors: B
authors: Nakstad
authors: Nanna
authors: N
authors: Voldner
authors: Odd H
authors: OH
authors: Rognerud-Jensen
authors: Sveinung
authors: S
authors: Berntsen
authors: Annhild
authors: A
authors: Mosdøl
authors: Torild
authors: T
authors: Skrivarhaug
authors: Mari H
authors: MH
authors: Vårdal
authors: Ingar
authors: I
authors: Holme
authors: Chittaranjan S
authors: CS
authors: Yajnik
authors: Kåre I
authors: KI
authors: Birkeland
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D016640:Diabetes, Gestational / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D004704:Endocrinology / Q000458:organization & administration; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007390:International Agencies / Q000458:organization & administration; D011153:Population; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D015995:Prevalence; D012107:Research Design; D012955:Societies, Medical / Q000458:organization & administration; D014944:World Health Organization; D055815:Young Adult