Maternal hyperglycemia according to IADPSG criteria as a predictor of perinatal complications in women with gestational diabetes: a retrospective observational study.
OBJECTIVE
We investigated the association between abnormal maternal glucose levels according to International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and perinatal complications.


METHODS
Retrospective observational study of data of 492 women in singleton pregnancy and gestational diabetes (GDM) diagnosed according to WHO criteria. Perinatal outcome and maternal characteristics were compared between normo- and hyperglycemic patients using IADPSG criteria and odds ratios calculated for particular outcomes.


RESULTS
Maternal fasting hyperglycemia (≥5.1 mmol/L) was associated with significantly higher proportion of birth weight ≥ 4000 g (19.3% versus 9.7%, p = 0.004, OR: 2.2; 95% CI: 1.3-3.8), gestational insulin therapy (27.7% versus 9.1%, p < 0.001, OR: 3.8; 95% CI: 2.3-6.5), poor long-term metabolic control (HbA1c at diagnosis ≥ 6.5% [48 mmol/mol]: 19.9% versus 4.6%, p < 0.001, OR: 5.2; 95% CI: 2.5-10.9). Pre-pregnancy obesity (BMI ≥ 30 kg/m(2), 26.0% versus 11.9%, p < 0.001, OR: 2.6; 95% CI: 1.6-4.3) and positive family history of diabetes (45.2% versus 30.8%, p < 0.002, OR: 1.8; 95% CI: 1.3-2.7) was more frequent in women with fasting hyperglycemia. Two-hour post-load hyperglycemia was only associated with increased prevalence of gestational hypertension (5.1% versus 11.4%, p = 0.046).


CONCLUSIONS
Women with fasting but not 2-h hyperglycemia according to IADPSG criteria are at significantly elevated risk of perinatal complications.
Department of Obstetrics and Women Diseases, University of Medical Sciences , Poznan , Poland and.
Agnieszka
A
Zawiejska
Ewa
E
Wender-Ozegowska
Sandra
S
Radzicka
Jacek
J
Brazert
D000328:Adult; D001786:Blood Glucose; D016640:Diabetes, Gestational / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D011044:Poland / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies
D001786:Blood Glucose
Fasting hyperglycemia; HAPO study; feto-maternal medicine; perinatal outcome