title: Impact of the International Association of Diabetes and Pregnancy Study Groups criteria for gestational diabetes.
abstract: OBJECTIVE
  To evaluate the diagnostic criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) and alternative criteria in terms of resultant prevalence of gestational diabetes mellitus (GDM) and measures of diagnostic impact.
  
  
  METHODS
  The Brazilian Gestational Diabetes Study (EBDG) is a cohort of pregnant women enrolled consecutively in prenatal care clinics of the Brazilian National Health Service from 1991 to 1995, a time and setting in which those with lesser than diabetes hyperglycemia rarely received drug treatment. Eligibility criteria were age ≥20 years, gestational age 20-28 weeks and no history of diabetes outside pregnancy. After interview and anthropometric measurements, a standardized 2h 75g OGTT was scheduled. Women were followed through early postpartum.
  
  
  RESULTS
  Prevalence of GDM defined by IADPSG criteria was 18.0% (95% CI 16.9-19.0), ranging from 2.7 to 17.0% with the alternative criteria. Relative risks for large for gestational age (LGA) and preeclampsia were generally small. The diagnostic impact assessed by pre- to post-test gain in the probability of an outcome was also small (3.6% for LGA and 0.5% for preeclampsia). Alternative criteria reached maximum gains of 9.7% and 5.3%, respectively. The fractions of LGA births and preeclampsia attributable to GDM by the IADPSG criteria were small, 6.7% and 3.5%, respectively.
  
  
  CONCLUSIONS
  The IADPSG criteria identify more women as having GDM but their diagnostic and population impacts with respect to adverse outcomes are small. Alternative definitions, although also presenting small diagnostic and population impacts, showed advantages which may be useful in specific settings.
authors.affiliation: Post Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: njtrujill@gmail.com.
authors.forename: Janet
authors.initials: J
authors.lastname: Trujillo
authors.affiliation: Post Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Vigo
authors.affiliation: Post Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Duncan
authors.affiliation: Post Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil.
authors.forename: Maicon
authors.initials: M
authors.lastname: Falavigna
authors.affiliation: Federal University of Health Sciences, Porto Alegre, Brazil.
authors.forename: Eliana M
authors.initials: EM
authors.lastname: Wendland
authors.affiliation: Conceição Hospital, Porto Alegre, Brazil.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Campos
authors.affiliation: Post Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis / Q000453:epidemiology; D005865:Gestational Age; D005951:Glucose Tolerance Test / Q000592:standards*; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000453:epidemiology; D007231:Infant, Newborn; D007390:International Agencies / Q000592:standards; D049590:Postpartum Period; D017410:Practice Guidelines as Topic / Q000592:standards; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care; D011379:Prognosis
keywords: Diagnostic criteria; Gestational diabetes mellitus; Large for gestational age; Preeclampsia