Clinical outcomes of pregnancies complicated with and treated for gestational diabetes mellitus: consequences of screening under the IADPSG criteria

Abstract

Aims

We diagnosed gestational diabetes mellitus according to the criteria of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG), treated gestational diabetes mothers in order to achieve normal glycemic levels, and evaluated clinical characteristics and pregnancy outcomes.

Methods

One hundred sixty pregnant women had oral glucose tolerance tests and were classified using the IADPSG criteria. Women with gestational diabetes received nutritional counseling, and insulin treatment was started if glycemic control, targeting below 100 mg/dl as fasting plasma glucose and below 120 mg/dl as 2-h postprandial plasma glucose, was not achieved with diet therapy.

Results

Out of 160 pregnancies, 31 women were diagnosed as having gestational diabetes. Insulin treatment was necessary for 14 women. Newborns from mothers with gestational diabetes were heavier than babies from normoglycemic mothers (3,194 ± 274 vs. 3,042 ± 388 g, p = 0.025). The rate of overall cesarean sections in gestational diabetes mothers was higher than the one in normoglycemic mothers (35.4 vs. 17.8 %, p = 0.031), although rates of primary cesarean sections were not different in the two groups. Neonatal hypoglycemia was more frequent in babies from gestational diabetes mothers (4 out of 25) than in newborns from normoglycemic mothers (3 out of 108) (p = 0.023).

Conclusions

The IADPSG criteria are more suitable for screening of gestational diabetes mellitus than the previous criteria. But even after making a diagnosis of gestational diabetes under the IADPSG criteria and extensive treatment, perinatal adverse events were not completely avoided.