Difference in the prevalence of gestational diabetes mellitus according to gestational age at 75‐g oral glucose tolerance test in Japan: The Japan Assessment of Gestational Diabetes Mellitus Screening trial

Iwama, Noriyuki; Sugiyama, Takashi; Metoki, Hirohito; Kusaka, Hideto; Yaegashi, Nobuo; Sagawa, Norimasa; Hiramatsu, Yuji; Toyoda, Nagayasu

doi:10.1111/jdi.13044

Cited by 15 publications

(14 citation statements)

References 24 publications

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“…It remains unknown whether the IADPSG criteria developed based on the results of the HAPO study of pregnant women between 24 and 32 weeks of gestation can be applied to different weeks of gestation to correctly detect abnormal glucose tolerance or pregnant women at high risk. Furthermore, OGTT results have been reported to vary according to the weeks of gestation [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: a case-control study

Shindo

Aoki

Nakanishi

et al. 2021

BMC Pregnancy Childbirth

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Background In 2010, the International Association of Diabetes and Pregnancy Study Group (IADPSG) proposed new criteria indicating that gestational diabetes mellitus (GDM) can be diagnosed if the fasting threshold of ≤92 mg/dL, 1-h threshold of ≤180 mg/dL, or 2-h threshold of ≤153 mg/dL are exceeded during the 75-g 2-h oral glucose tolerance test (OGTT) performed at 24–28 weeks of gestation. The World Health Organization (WHO) recommends using the proposed diagnostic threshold values of the IADPSG to diagnose GDM; however, it does not limit the timing of the 75-g OGTT. Since 2010 in Japan, GDM has been diagnosed using the same criteria as that proposed by the WHO. However, neither the JSOG nor the WHO has provided any evidence that it is appropriate to use a threshold beyond the range recommended by the IADPSG. Methods This was a single-centre retrospective study based on the medical records and delivery registry database of our centre. We included women who underwent a 50-g glucose challenge test (GCT) with results < 140 mg/dL at 24–28 weeks of gestation and subsequently underwent a 75-g OGTT after 29 weeks of gestation with abnormal glucose tolerance suspected based on clinical findings. The reference values for the 75-g OGTT followed the IADPSG criteria. Subjects were classified into the normal glucose tolerance (NGT) group and the GDM group. The type of delivery and neonatal outcomes of the two groups were compared. A multivariable analysis was performed to match the backgrounds of both groups. Results In total, the NGT and GDM group comprised 189 and 49 women, respectively. Emergency caesarean delivery rates were similar in the GDM and NGT groups (10.6 and 12.2%, respectively; adjusted odds ratio [OR], 1.25; 95% confidence interval [CI], 0.43–3.64; p = 0.74); however, the elective caesarean delivery rate was higher in the GDM group than in the NGT group (16.3 and 5.3%, respectively, adjusted OR, 3.60; 95% CI, 1.27–10.19; p = 0.01). No significant differences were observed in other maternal and neonatal outcomes between both groups. Conclusion Although a diagnosis of GDM during the third trimester does not improve pregnancy outcomes, it increases the elective caesarean delivery rate.

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Section: Discussionmentioning

confidence: 99%

Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: a case-control study

Shindo

Aoki

Nakanishi

et al. 2021

BMC Pregnancy Childbirth

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“…Those studies might have overestimated the prevalence, because Morikawa et al 26,27 . included women with diabetes mellitus, and the study by Iwama et al 28 . was a multicenter study involving relatively large hospitals that treated high‐risk pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Association between pre‐pregnancy body mass index and gestational weight gain and perinatal outcomes in pregnant women diagnosed with gestational diabetes mellitus: The Japan Environment and Children's Study

Saito

Kobayashi

Ikeda‐Araki

et al. 2021

J of Diabetes Invest

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Aims/Introduction We investigated the association between gestational diabetes mellitus (GDM) and perinatal outcomes stratified by pre‐pregnancy body mass index (BMI) and/or gestational weight gain (GWG). Materials and Methods Data from the national birth cohort in the Japan Environment and Children's Study from 2011 to 2014 (n = 85,228) were used. Japan uses the GDM guidelines of the International Association of Diabetes and Pregnancy Study Groups. The odds ratios (ORs) of perinatal outcomes were compared between women with and those without GDM. Results The OR (95% confidence interval) of having a small for gestational age infant in the GDM group with a pre‐pregnancy BMI of ≥25.0 kg/m2 and insufficient GWG (<2.75 kg) was 1.78 (1.02–3.12). The OR of having a large for gestational age infant of the same BMI group with excessive GWG (>7.25 kg) was 2.04 (1.56–2.67). The OR of hypertensive disorders of pregnancy was higher in women with a BMI ≥18.5 kg/m2 in the GDM group than in the non‐GDM group. Conclusions Large for gestational age and hypertensive disorders of pregnancy were associated with pre‐pregnancy BMI and GWG in either normal weight or overweight/obese women, and the relationship was strengthened when GDM was present. Women with GDM and a BMI of ≥25.0 kg/m2 are at risk of having small for gestational age and large for gestational age infants depending on GWG.

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“…It remains unknown whether the IADPSG criteria developed on the basis of the results of the HAPO study of pregnant women between 24 and 32 weeks of gestation can be applied to different weeks of gestation to correctly detect abnormal glucose tolerance or pregnant women at high risk. Furthermore, OGTT results have been reported to vary according to the weeks of gestation (15,16).…”

Section: Discussionmentioning

confidence: 99%

Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: A case control study

Shindo

Aoki

Nakanishi

et al. 2020

Preprint

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Background: In 2010, the International Association of Diabetes and Pregnancy Study Group (IADPSG) proposed new criteria indicating that gestational diabetes mellitus (GDM) can be diagnosed if the fasting threshold of ≤92 mg/dL, 1-hour threshold of ≤180 mg/dL, or 2-hour threshold of ≤153 mg/dL are exceeded during the 75-g 2-hour oral glucose tolerance test (OGTT) performed at 24–28 weeks of gestation. The World Health Organization (WHO) recommends using the proposed diagnostic threshold values of the IADPSG to diagnose GDM, but it does not limit the timing of the 75-g OGTT. Since 2010 in Japan, GDM has been diagnosed using the same criteria as that proposed by the WHO. Nevertheless, there is no justification for these thresholds during specific time windows.Methods: This was a single-centre retrospective study based on the medical records and delivery registry database of our centre. We included women who underwent a 50-g glucose challenge test (GCT) with results <140 mg/dL at 24–28 weeks of gestation and subsequently underwent a 75-g OGTT after 29 weeks of gestation with abnormal glucose tolerance suspected based on clinical findings. The reference values for the 75-g OGTT followed the IADPSG criteria. Subjects were classified as the normal glucose tolerance (NGT) group and the GDM group. The type of delivery and neonatal outcomes of the two groups were compared. A multivariable analysis was performed to match the backgrounds of both groups.Results: A total of 189 women comprised the NGT group and 49 women comprised the GDM group. Emergency caesarean delivery rates were similar in the GDM and NGT groups (10.6% and 12.2%, respectively; adjusted odds ratio [OR], 1.25; 95% confidence interval [CI], 0.43-3.64; p=0.74), but the elective caesarean delivery rate was higher in the GDM group than in the NGT group (16.3% and 5.3%, respectively, adjusted OR, 3.60; 95% CI, 1.27-10.19; p=0.01). There were no differences in other maternal and neonatal outcomes between groups.Conclusion: Whether diagnosing GDM during the third trimester can improve pregnancy outcomes is unknown. However, pregnant women diagnosed with GDM during the third trimester are more likely to undergo caesarean delivery.

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Difference in the prevalence of gestational diabetes mellitus according to gestational age at 75‐g oral glucose tolerance test in Japan: The Japan Assessment of Gestational Diabetes Mellitus Screening trial

Cited by 15 publications

References 24 publications

Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: a case-control study

Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: a case-control study

Association between pre‐pregnancy body mass index and gestational weight gain and perinatal outcomes in pregnant women diagnosed with gestational diabetes mellitus: The Japan Environment and Children's Study

Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: A case control study

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