title: Impact of the Implementation of New WHO Diagnostic Criteria for Gestational Diabetes Mellitus on Prevalence and Perinatal Outcomes: A Population-Based Study.
abstract: Objectives. To determine the impact of the implementation of new WHO diagnostic criteria for gestational diabetes mellitus (GDM) on prevalence, predictors, and perinatal outcomes in Croatian population.Methods. A cross-sectional study was performed using data from medical birth certificates collected in 2010 and 2014. Data collected include age, height, and weight before and at the end of pregnancy, while perinatal outcome was assessed by onset of labor, mode of delivery, and Apgar score.Results. A total of 81.748 deliveries and 83.198 newborns were analysed. Prevalence of GDM increased from 2.2% in 2010 to 4.7% in 2014. GDM was a significant predictor of low Apgar score (OR 1.656), labor induction (OR 2.068), and caesarean section (OR 1.567) in 2010, while in 2014 GD was predictive for labor induction (OR 1.715) and caesarean section (OR 1.458) only. Age was predictive for labor induction only in 2014 and for caesarean section in both years, while BMI before pregnancy was predictive for all observed perinatal outcomes in both years.Conclusions. Despite implementation of new guidelines, GDM remains burdened with increased risk of labor induction and caesarean section, but no longer with low Apgar score, while BMI remains an important predictor for all three perinatal outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Merkur, Zajčeva 19, 10 000 Zagreb, Croatia.
authors.forename: Katja
authors.identifier: 0000-0001-5992-5030
authors.initials: K
authors.lastname: Erjavec
authors.affiliation: Department of Medical Informatics and Biostatistics, Croatian Institute of Public Health, Rockefellerova 7, 10 000 Zagreb, Croatia.
authors.forename: Tamara
authors.initials: T
authors.lastname: Poljičanin
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Merkur, Zajčeva 19, 10 000 Zagreb, Croatia; Department of Obstetrics and Gynecology, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia.
authors.forename: Ratko
authors.initials: R
authors.lastname: Matijević
mesh_terms: D000328:Adult; D001034:Apgar Score; D015992:Body Mass Index; D017523:Croatia / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008423:Maternal Age; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D014944:World Health Organization