Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications

Abstract

Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is associated with adverse pregnancy outcomes and long-term offspring and maternal complications. For GDM screening and diagnosis, a two-step approach (1-hour 50 g glucose challenge test followed by 3-hour 100 g oral glucose tolerance test) has been widely used. After the Hyperglycemia and Adverse Pregnancy Outcome study implemented a 75 g oral glucose tolerance test in all pregnant women, a one-step approach was recommended as an option for the diagnosis of GDM after 2010. The one-step approach has more than doubled the incidence of GDM, but its clinical benefit in reducing adverse pregnancy outcomes remains controversial. Long-term complications of mothers with GDM include type 2 diabetes mellitus and cardiovascular disease, and complications of their offspring include childhood obesity and glucose intolerance. The diagnostic criteria of GDM should properly classify women at risk for adverse pregnancy outcomes and long-term complications. The present review summarizes the strengths and weaknesses of the one-step and two-step approaches for the diagnosis of GDM based on recent randomized controlled trials and observational studies. We also describe the long-term maternal and offspring complications of GDM.

Stacking Ensemble Method for Gestational Diabetes Mellitus Prediction in Chinese Pregnant Women: A Prospective Cohort Study

“…e sum of the scores for the seven components was calculated for each participant, with a higher score indicating worse sleep quality. Sleep quality was classified according to the score achieved: poor (PSQI score of [16][17][18][19][20][21], general (PSQI score of [11][12][13][14][15], better (PSQI score of 6-10), and best (PSQI score of 0-5).…”

“…In particular, women with a history of GDM have a nearly 10-fold higher risk of type 2 diabetes than women with normoglycemic pregnancy [ 10 ]. For offspring, GDM is also associated with an increased risk of childhood obesity [ 11 ] and glucose intolerance [ 12 ].…”

Is low vitamin D status in pregnancy associated with adverse outcomes? ：a prospective cohort study

“…Evidence of other maternal organ dysfunction; liver involvement with or without right upper quadrant or epigastric abdominal pain, neurological complications; or hematological complications; or 3.uteroplacental dysfunction [13] . GDM was diagnosed after all women underwent a 75-g oral glucose tolerance test between 24 and 28 weeks of pregnancy, we also applied IADPSG criteria (one or more fasting, 1-h, or 2-h plasma glucose concentrations equal to or greater than threshold values of 5.1, 10.0, or 8.5 mmol/L, respectively) to diagnose GDM [14] . Early Preterm delivery, defined by a gestational age before 34 weeks.…”

Secular increase in the prevalence of gestational diabetes and its associated adverse pregnancy outcomes from 2014 to 2021 in Hebei province, China

“…The incidence of GDM in China was reported to be 11.91% ( 3 ). Women with GDM are more likely to experience an adverse outcome, including Cesarean delivery, preeclampsia, soft issue injury of the birth canal, and severe maternal morbidity ( 4 ). An increasing number of studies have shown that women with a history of GDM are at an increased risk of being diagnosed as having type 2 diabetes ( 5 ).…”

“…In addition to the short-term perinatal consequences associated with GDM, there are long-term complications for newborns. Studies have found that the risks of obesity, metabolic syndrome, type 2 diabetes, and impaired insulin sensitivity and secretion in offspring of mothers with GDM are 2- to 8-fold of those in offspring of mothers without GDM ( 4 ).…”