Pregnancy Outcomes in Women With and Without Gestational Diabetes Mellitus According to The International Association of the Diabetes and Pregnancy Study Groups Criteria

OBJECTIVE: To estimate the incidence of gestational diabetes mellitus (GDM) according to The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria and the pregnancy complications in women fulfilling these criteria but who are not considered diabetic according to the Canadian Diabetes Association criteria. METHODS: We estimated the rate of GDM according to the IADPSG criteria from November 2008 to October 2010. Then, we conducted a chart review to compare maternal and neonatal outcomes between women classified as GDM according to the IADPSG criteria but not by the Canadian Diabetes Association criteria (group 1; n = 186) and nondiabetic women according to both criteria (group 2; n = 372). Results were expressed as crude (odds ratio [OR]) or adjusted OR and 95% confidence interval (CI). The study has a statistical power of 80% to detect a difference between 16% and 8% in large for gestational age newborns (alpha level of 0.05; two-tailed). RESULTS: The rate of GDM using the IADPSG criteria was 27.51% (95% CI 25.92-29.11). Group 1 presented similar rates of large-for-gestational-age newborns (9.1% compared with 5.9%, adjusted OR 1.58, 95% CI 0.79-3.13; P = .19), delivery complications (37.1% compared with 30.1%, OR 1.37, 95% CI 0.95-1.98; P = .10), pre-eclampsia (6.5% compared with 2.7%, adjusted OR 2.40, 95% CI 0.92-6.27; P = .07), prematurity (6.5% compared with 2.7%, OR 1.10, 95% CI 0.53-2.27; P = .85), neonatal complications at delivery (13.4% compared with 9.7%, OR 1.45, 95% CI 0.84-2.49; P = .20), and metabolic complications (10.8% compared with 14.2%, OR 0.73, 95% CI 0.42-1.26; P = .29) compared with group 2. CONCLUSION: Women classified as nondiabetic by the Canadian Diabetes Association Criteria but considered GDM according to the IADPSG criteria have similar pregnancy outcomes as women without GDM. More randomized studies with cost-effectiveness analyses are needed before implementation of these criteria. (Obstet Gynecol 2012; 120: 746-52) DOI:http://10.1097/AOG.0b013e31826994ec