Effects of Implementing International Association of Diabetes and Pregnancy Study Groups Gestational Diabetes Screening on Pregnancy Outcomes at a Small Community Teaching Hospital

Abstract

IN BRIEF Traditional methods of screening for and diagnosing gestational diabetes mellitus (GDM) have been challenged, leading to the development of new screening guidelines by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). This study is a retrospective comparison of pregnancy outcomes based on the Carpenter and Coustan (CC) and IADPSG screening guidelines. It demonstrates that adoption of IADPSG guidelines increased the rate of GDM diagnosis and resulted in more women with diet-controlled GDM. However, a decrease in adverse pregnancy outcomes was not noted. Interestingly, women diagnosed by IADPSG criteria who had diet-controlled GDM had less maternal weight gain than those screened with the CC criteria who did not have GDM but did have an elevated 1-hour oral glucose tolerance test result.

Change in prevalence of gestational diabetes and obstetric complications when applying IADPSG screening criteria in a Belgian French speaking University Hospital. A retrospective cohort study

“…Similar results were seen in other retrospective studies [7, 8, 10], in particular the one by Ortio et al, where GDM prevalence went from 8 to 23% [11].…”

IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria

“…It is noticed that women identified to have GDM by the IADPSG's diagnostic criteria had an increased risk for adverse perinatal outcomes as compared to women identified by others' diagnostic criteria, e.g., the WHO's criteria [19]. A switch from others' diagnostic criteria to the IADPSG's was expected to result in an increase in the prevalence of GDM, which has been confirmed in a number of studies [8,[20][21][22][23] national databases and found that overall national prevalence of GDM increased from 3.1% in 2008 to 14.8% in 2017, a fivefold increase mainly due to use of the IADPSG's diagnostic criteria [24]. An early meta-analysis reported a sharp difference in the prevalence of GDM by different diagnostic criteria, with 1.5-15.5% by the ADA's criteria, 20.8% by the Australian Diabetes in Pregnancy Society's criteria, 13.6% by the Diabetes in Pregnancy Study Group India's criteria, 1.6% by the European Association for the Study of Diabetes' criteria, 0.56% by the National Diabetes Data Group's criteria and 0.4-24.3% by the WHO 1999's criteria, in contrast to 8.9-20.4% by the IADPSG's criteria [25].…”

Effect of the IADPSG screening strategy for gestational diabetes on perinatal outcomes in Switzerland

“…The new IADPSG screening strategy has been topic of extensive debate, as a rise in incidence of GDM and an increased burden on a number of health care systems were shown [10][11][12]. Even though, by adopting the IADPSG screening criteria, cost savings and improved pregnancy outcomes have been found in some studies [13,14], others did not find similar benefits [15,16]. This former switch from a risk-based to a universal GDM screening recommended by the IADPSG has been also criticized for contributing to a medicalization of previously healthy pregnancies, with potential implications on women's quality of life [10].…”