Is mild gestational hyperglycaemia associated with maternal and neonatal complications? The Diagest Study

Abstract

This study suggested that the increased rate of adverse maternal and fetal outcome, especially LGA, was associated with untreated mild gestational hyperglycaemia women compared to a control group. This link to lower degrees of hyperglycaemia during pregnancy is independent of confounding factors.

Gestational Diabetes and the Metabolic Syndrome

“…(Schmidt et al, 2001) and similar results were observed using the WHO criteria. Some speculate that the restrictive diagnostic criteria for GDM may overlook the risks faced by women with lesser degrees of dysglycemia (Ferrara et al, 2007;Vambergue et al, 2000). Others assert that lack of international uniformity and agreement of diagnostic thresholds for GDM limits their utility within clinical settings (Metzger & Coustan, 1998).…”

Evaluation of the incidence and outcome of gestational diabetes mellitus using the current international consensus guidelines for diagnosing hyperglycaemia in pregnancy

“…10 Some suggest that criteria currently in wide use for the diagnosis of GDM are too restrictive and that lesser degrees of hyperglycemia increase risk of adverse perinatal outcomes. [11][12][13][14][15][16] Conversely, others believe that systematic efforts to identify GDM should be stopped unless data become available to link significant morbidities to specific degrees of glucose intolerance. 8 Lack of international uniformity in the approach to ascertainment and diagnosis of GDM has been a major hurdle.…”

Fetal Macrosomia in the Diabetic Woman

“…The recurrence of gestational diabetes in future pregnancies is between 20 and 50%, which may serve to explain the recurrence of macrosomia in some families, afterwards followed by the onset of maternal diabetes in 50% of the women after approximately 10 years from the onset of gestational diabetes and from the birth of a child, and in 70% of the women who have gestational diabetes and two children [12,13]. Women who gave birth to macrosomic children had the following statistically significant variables compared to the control group: a higher age, obesity (defined as a weight in excess of 90 Kg), diabetes (gestational or pre-existing) and post-maturity (more than 42 weeks of gestation).…”