Local versus international criteria in predicting gestational diabetes mellitus-related pregnancy outcomes.
- Author:
Serafica-Hernandez Shalimar A
;
Espina-Tan Charisse
;
Tremedal Ma. Asuncion
;
Diaz-Roa Larisa Julia
- Publication Type:Journal Article, Original
- MeSH: Human; Female; Adult; Pregnancy; Glucose Tolerance Test; Diabetes, Gestational; Pregnancy Outcome; Blood Glucose; Birth Weight; Glucose; Cesarean Section; Pregnancy In Diabetics
- From: Philippine Journal of Obstetrics and Gynecology 2014;38(1):33-42
- CountryPhilippines
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the Philippine Obstetrical and Gynecological Society Clinical Practice Guidelines (POGS-CPG) and the International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria for gestational diabetes mellitus (GDM) against pregnancy outcomes.
METHODS: This is a randomized controlled trial which enlisted patients attending the Out-patient clinic of our institution. All women included in the study were requested to take a 2-hour 75-gram oral glucose tolerance test (OGTT) between estimated 24th and 28th gestational weeks. In order to diagnose GDM, POGS-CPG consensus required a fasting plasma glucose of >92 mg/dl (5.1 mmol/L) or a 2-hour post-glucose load of >140 mg/dl (7.8 mmol/ml) while lADPSG criteria required 92 mg/dL (5.1 mmol/L) for fasting plasma glucose, 180 mg/dL (10 mmol/L)
1-hour post-glucose load, or 153 mg/dL (8.5 mmol/L) 2-hour post-glucose load. Only 1 abnormal value on the OGTT is needed on both criteria to diagnose GDM. Women with diabetes antedating pregnancy were excluded in this study. Based on the 75-g OGTT result, the patients were divided into 4 groups and were followed through delivery. Pregnancy out-comes of the 4 groups were then compared.
RESULTS: Among the 389 patients studied, POGS-CPG group had a GDM prevalence rate of 29% whereas the IADPSG group had 16%. Trends have shown that in patients diagnosed with GDM under IADSGP and POGS criteria, no significant differences in the birth-weight status (p=0.156), mode of delivery (p=1.000), indication of cesarean section (p=1.000), and other complications (p=1.000) were noted. The 75 g OGTT values of patients in both groups were not significant predictors of APGAR scores. However, the 1-hour post-glucose load value was shown to be a significant
predictor of birth weight. Yet, the regression models of FBS parameters in predicting APGAR scores and birth weight were still weak.
CONCLUSION: There was no significant difference noted between the IADPSG group versus the POGS-CPG group in terms of maternal neonatal outcome.