Philippine Journal of Internal Medicine 2017;55(4):1-8
Diagnosis of gestational diabetes mellitus using the international association of the diabetes and pregnancy study groups criteria and adverse pregnancy outcomes among a cohort of Filipino women: An association analysis
Kristine S. de Luna 1 ; Elaine C. Cunanan 2
Affiliations
Keywords
IADPSG criteria; 75-gram oral glucose tolerance test; Adverse pregnancy outcomes
Country
Philippines
Language
English
MeSH
ACTIONS
Abstract
Introduction:Locally, there is no unified set of diagnostic
criteria for gestational diabetes mellitus (GDM) and this can
lead to potential confusion on the part of the physician and
the patient as well. Moreover, whether the adoption of the
International Association of the Diabetes and Pregnancy
Study Groups (IADPSG) threshold values for GDM diagnosis
among Filipino women is appropriate is still unclear. This study
serves to give a clinically important insight whether utilizing
the abovementioned diagnostic criteria is appropriate in
the local setting or not. The study aims to determine the
association of the threshold values set up by the IADPSG to
diagnose GDM with adverse pregnancy outcomes among
a cohort of Filipino women.
Methods:A retrospective analysis of medical files of the
women diagnosed with GDM using the IADPSG criteria from
January 2013 to March 2016 was done. The results of seventyfive gram oral glucose tolerance test (75-g OGTT) were
recorded. The association between each IADPSG threshold
values (fasting blood glucose of ≥92 mg/dL, one-hour post
glucose load of ≥180 mg/dL, two-hour post glucose load
of ≥153 mg/dL) used to define GDM and maternal and
perinatal outcomes were determined.
Results:One hundred twenty women with GDM were
included in the analysis. Each of IADPSG-defined cut-off values was not significantly associated with increased
likelihood of having adverse maternal outcomes namely:
hypertensive disorders of pregnancy, miscarriage, primary
cesarean section, operative vaginal delivery, and maternal
death. Similarly, the likelihood of perinatal outcomes namely:
macrosomia, perinatal death, prematurity, birth injuries,
congenital anomalies, neonatal hypoglycemia, jaundice,
low APGAR score, acute respiratory distress syndrome, and
infection were not significantly higher even if these cut-off
values were met. Of note, high odds ratio was noted for neonatal
hypoglycemia at FBS >92 mg/dL and <92 mg/dL and the low
Apgar Score in first minute at >153 mg/dL and <153 mg/dL
even though they were statistically not significant.
Conclusion:We did not find a statistically significant positive association between IADPSG threshold values and specified adverse maternal and perinatal outcomes.
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