New guidelines for screening, diagnosing, and treating gestational diabetes – evaluation of maternal and neonatal outcomes in Finland from 2006 to 2012

Ellenberg, Anni; Sarvilinna, Nanna; Gissler, Mika; Ulander, Veli-Matti

doi:10.1111/aogs.13074

Cited by 19 publications

(20 citation statements)

References 23 publications

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“…Before 2008, GDM diagnosis was made if at least one of the following plasma glucose levels was observed in the 75-g oral glucose tolerance test: fasting value ⩾5.1 mmol/L, 1 h value ⩾10.0 mmol/L, or 2 h value ⩾8.6 mmol/L. 12 The oral glucose tolerance test was recommended at gestational weeks 24-28 for pregnant women with a pre-pregnancy body mass index (BMI) ⩾25 kg/m 2 , presence of glycosuria, age >40 years, fetal macrosomia in current or previous pregnancy, GDM in previous pregnancy, or a first-degree family history of diabetes. 12 Since 2008, GDM has been diagnosed when with fasting plasma glucose value ⩾5.3 mmol/L, the 1 h value ⩾10.0 mmol/L, or the 2 h value ⩾8.6 mmol/l.…”

Section: Discussionmentioning

confidence: 99%

“…12 The oral glucose tolerance test was recommended at gestational weeks 24-28 for pregnant women with a pre-pregnancy body mass index (BMI) ⩾25 kg/m 2 , presence of glycosuria, age >40 years, fetal macrosomia in current or previous pregnancy, GDM in previous pregnancy, or a first-degree family history of diabetes. 12 Since 2008, GDM has been diagnosed when with fasting plasma glucose value ⩾5.3 mmol/L, the 1 h value ⩾10.0 mmol/L, or the 2 h value ⩾8.6 mmol/l. 24 The oral glucose tolerance test is recommended for all pregnant women, except those at low risk (nulliparous women <25 years old with normal BMI and no family history of type 2 diabetes, and parous women <40 years old with normal BMI and no GDM or macrosomic child in a previous pregnancy).…”

Section: Discussionmentioning

confidence: 99%

“…9,10 A few studies have reported the general prevalence of gestational diabetes and hypertensive disorders in the European countries. [11][12][13] However, limited information is available on pregnancy complications in women of migrant origin in the European countries. [14][15][16] This would be important since studies in non-pregnant populations suggest that many migrant groups have higher prevalence of type 2 diabetes or hypertension compared with the general population.…”

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Pregnancy complications in women of Russian, Somali, and Kurdish origin and women in the general population in Finland

Bastola

Koponen

Härkänen

et al. 2020

Womens Health (Lond Engl)

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Objective: We compared the prevalence of gestational diabetes and hypertensive disorders in the most recent pregnancy among women of Russian, Somali, and Kurdish origin and women in the general population in Finland. Methods: The study groups were selected from population-based samples of 18- to 64-year-old women. The women were of Russian (n = 318), Somali (n = 583), and Kurdish (n = 373) origin or from the general population (n = 243), and had given birth in Finland between 2004 and 2014. The data were obtained from the National Medical Birth Register and the Hospital Discharge Register. Data on gestational diabetes and hypertensive disorders were extracted based on relevant International Classification of Diseases, Tenth Revision codes. The main statistical methods were logistic regression analyses adjusted for age, parity, body mass index, socioeconomic status, and smoking. Results: The prevalence of gestational diabetes was 19.1% in Kurdish, 14.4% in Somali, 9.3% in Russian, and 11.8% in the general population. The prevalence of hypertensive disorders was 5.4% in the general population, 3.8% in Somali, 3.1% in Kurdish, and 1.7% in Russian. When adjusted for confounders, Kurdish women had two-fold odds for gestational diabetes (odds ratio = 1.98; 95% confidence interval = 1.20–3.32) compared with the general population, but the odds for hypertensive disorders did not differ between groups. Conclusion: Women of Kurdish origin were more likely to develop gestational diabetes. Studies with larger samples are required to confirm these findings to develop prevention strategies for later development of type 2 diabetes. Future research including other migrant groups is recommended to identify differences in pregnancy complications among the women in migrant and general population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Pregnancy complications in women of Russian, Somali, and Kurdish origin and women in the general population in Finland

Bastola

Koponen

Härkänen

et al. 2020

Womens Health (Lond Engl)

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“…The use of comprehensive screening has resulted in an increase in the incidence of GDM during recent years. 22 , 23 The screening frequency has increased from 51.4% in 2009–12 to 66.0% in 2018, and the prevalence of GDM increased from 11.3% to 21.3%, respectively. 24 Thus, some women with GDM remained undiagnosed when our study was conducted.…”

Section: What Are the Main Strengths And Weaknesses?mentioning

confidence: 99%

Cohort Profile: The Finnish Gestational Diabetes (FinnGeDi) Study

Keikkala

Mustaniemi

Koivunen

et al. 2020

International Journal of Epidemiology

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“…Some previous studies showed that gestational diabetes mellitus (GDM) was not signi cantly correlated with NA [17,23]. While recent research has demonstrated that, a 1% increase (a unit increase) in HbA1c was observed to be associated with 2.99 times higher odds of NA [95%CI 1.31, 3.85] [24].…”

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confidence: 99%

Maternal Low Fasting Plasm Glucose in the Second Trimester is Associated with Neonatal Asphyxia

Yuan

Yang

et al. 2020

Preprint

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Background Neonatal asphyxia (NA) is associated with neonatal respiratory distress syndrome, cerebral palsy and neonatal death. Risk factors for NA have been identified as maternal hypertension, premature birth and anemia. While the effect of maternal fasting plasm glucose (FPG) in the second trimester of pregnancy on NA remains unclear. Method Retrospective data from 9661 singleton newborns and mothers were analyzed from January 2016 to July 2018 in Tongzhou district, Beijing. Multivariate logistic regression was used to investigate the risk factors of NA, adjusted for gestational hypertension, triglyceride in the second trimester of pregnancy, fetal distress in utero and preterm birth. Results Of the 9,661 newborns, 26 (2.7‰) were diagnosed with neonatal death (Apgar score 1min = 0) and 52 (5.4‰) with varying degrees of asphyxia (Apgar score 1min = 1 to 6). The asphyxia group showed lower FPG [asphyxia group vs non-asphyxia group, 4.5±0.4 vs 4.8±0.5 mmol/L, P<.01], higher triglyceride level (asphyxia group vs non-asphyxia group, 3.0±1.3 vs 2.5±1.9 mmol/L P<.01) in the second trimester, higher rates of gestational hypertension, fetal distress in utero, preterm birth than the non-asphyxia group (P<.05). Multivariate logistic regression revealed that lower FPG in the second trimester was an independent risk factor of NA [adjusted odds ratio (AOR) 0.26; 95% CI 0.08 to 0.80]. Conclusion Pregnant women with low fasting glucose in the second trimester of pregnancy are at increased risk of birth asphyxia in their offspring.

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New guidelines for screening, diagnosing, and treating gestational diabetes – evaluation of maternal and neonatal outcomes in Finland from 2006 to 2012

Abstract: In conclusion, glucose tolerance tests were performed twice as often as a result of the implementation of the national GDM guidelines, but this comprehensive screening practice did not improve pregnancy and neonatal outcomes.

Cited by 19 publications

References 23 publications

Pregnancy complications in women of Russian, Somali, and Kurdish origin and women in the general population in Finland

Pregnancy complications in women of Russian, Somali, and Kurdish origin and women in the general population in Finland

Cohort Profile: The Finnish Gestational Diabetes (FinnGeDi) Study

Maternal Low Fasting Plasm Glucose in the Second Trimester is Associated with Neonatal Asphyxia

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