title: Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria.
abstract: OBJECTIVE
  The International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria for gestational diabetes are associated with increased prevalence. However, it remains unknown if intervention for more women with gestational diabetes mellitus by the IADPSG criteria results in better pregnancy outcomes than adopting the Carpenter and Coustan (C&C) criteria in Asian populations.
  
  
  METHODS
  This was a retrospective cohort study. A total of 1,840 women, 952 subjects by the IADPSG criteria and 888 subjects by the C&C criteria, who delivered singletons in 2011 in a single tertiary center, were included in the study. The same therapeutic interventions were offered to women with gestational diabetes mellitus by the two criteria. Maternal and neonatal outcomes were evaluated.
  
  
  RESULTS
  Adopting the IADPSG criteria increased the prevalence of gestational diabetes mellitus diagnosis to 13.44%, compared with 2.59% by the C&C criteria. The diagnosis was made 3 weeks earlier by the IADPSG criteria (27 vs 30.5 weeks, P < 0.0001). Adopting the IADPSG criteria was associated with reduced risk of primary cesarean section (adjusted odds ratio 0.79, 95% confidence interval 0.63-0.998, P < 0.05) and having any one of the adverse fetal outcomes (adjusted odds ratio 0.79, 95% confidence interval 0.64-0.998, P < 0.05), including birthweight >90th percentile, jaundice, admission to neonatal intensive care unit, birth trauma, neonatal hypoglycemia and fetal death.
  
  
  CONCLUSIONS
  Adopting the IADPSG criteria is associated with improved pregnancy outcomes, at the expense of increased prevalence of gestational diabetes mellitus diagnosis.
authors.affiliation: Department of Obstetrics and Gynecology Dianthus MFM Clinic National Taiwan University Hospital Taipei Taiwan.
authors.forename: En-Tzu
authors.initials: ET
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine Yun-lin Branch National Taiwan University Hospital Yun-lin Taiwan.
authors.forename: Feng-Jung
authors.initials: FJ
authors.lastname: Nien
authors.affiliation: Department of Internal Medicine New Taipei City Hospital New Taipei City Taiwan.
authors.forename: Chun-Heng
authors.initials: CH
authors.lastname: Kuo
authors.affiliation: Department of Internal Medicine New Taipei City Hospital New Taipei City Taiwan.
authors.forename: Szu-Chi
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine Hsin-Chu Branch National Taiwan University Hospital Hsin-Chu Taiwan.
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan.
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
authors.affiliation: Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan.
authors.forename: Hung-Yuan
authors.initials: HY
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology National Taiwan University Hospital Taipei Taiwan.
authors.forename: Chien-Nan
authors.initials: CN
authors.lastname: Lee
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D038622:Internationality; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: Carpenter and Coustan criteria; Gestational diabetes; International Association of the Diabetes and Pregnancy Study Group criteria
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