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.

Gestational diabetes in primiparous women–impact of age and adiposity: a register‐based cohort study

“…Further, according to our study findings the primiparous women with GDM had more large‐for‐gestational‐age newborns than did the women without GDM. This finding is in line with several previous study findings .…”

Women’s experiences of a diagnosis of gestational diabetes mellitus: a systematic review

“…In many countries the prevalence of GDM is rising [14][15][16]. Some of this is due to the increasing age at which women are becoming pregnant, an increase in obesity amongst women, more testing during pregnancy, and better recording during pregnancy.…”

“…Despite a significant increase in prevalence of GDM after the introduction of the new IADPSG criteria [15,16], some pre-post studies suggest negligible clinical improvement in the adverse outcomes measured [17,18]. Findings from a qualitative study of 19 women of different cultural backgrounds investigating women's experiences of a GDM diagnosis reported that the diagnostic criteria itself was viewed as 'confusing' by some women and treatment for their 'borderline' condition unnecessary [19].…”

Effect of new diagnostic criteria on detection and pregnancy outcomes of gestational diabetes mellitus: a retrospective study

“…Based on the new diagnostic criteria, the number of GDM cases detected in our cohort reduced 2.9%. Nonetheless, most studies reported an increase in the number of GDM cases [15][16][17][18][19][20] , although some studies reported similar or decreased in number of GDM cases. 21,22 This reduction reflected that most GDM cases detected in the Chinese population was by the 2HG test.…”