The impact of implementing the WHO-2013 criteria for gestational diabetes mellitus on its prevalence and pregnancy outcomes: A comparison of the WHO-1999 and WHO-2013 diagnostic thresholds. (March 2020)

• Record Type: Journal Article
• Authors: Shareef, Madena; Saleh, Langeza; van den Meiracker, Anton H.; Visser, Willy
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 246(2020)
• Page Start: 14
• Page End: 18
• Publication Date: 2020-03
• Subjects: BMI body mass index -- CS caesarean section -- DM diabetes mellitus -- GDM gestational diabetes mellitus -- HAPO Hyperglycemia and Adverse Pregnancy Outcomes study -- IADPSG The International Association of the Diabetes and Pregnancy Study Groups -- LGA large for gestational age -- NICU neonatal intensive care unit -- OGTT oral glucose tolerance test -- PE preeclampsia -- PIH pregnancy induced hypertension -- SGA small for gestational age -- WHO World Health Organization; Gestational diabetes mellitus -- World Health Organization -- Pregnancy outcomes -- 75 g oral glucose tolerance test (OGTT); Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2019.12.013
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Aims/hypothesis: To determine the impact of implementing the new WHO-2013 criteria on prevalence of gestational diabetes mellitus (GDM) and pregnancy outcomes compared to the WHO-1999 criteria. Methods: A retrospective study conducted in pregnant women who were referred to the Erasmus MC for an oral glucose tolerance test (OGTT) between 2010 and 2015. Results: Of 3089 women, 11.5 % (n = 354) were diagnosed with GDM based on the WHO-1999 criteria and 17.0 % (n = 524) based on the 2013–criteria, with 97 (3.1 %) reclassified as non-GDM and 267 (8.6 %) reclassified as GDM when shifting from the 1999 to 2013-criteria. In contrast to 60 % of patients in the WHO-2013 group, only 2 % of the WHO-1999 group was diagnosed with GDM because of an elevated fasting glucose only. Patients reclassified as GDM by WHO-2013 criteria had a higher body mass index (p < 0.001) and delivered babies with a higher birth weight (p = 0.01). Maternal and neonatal adverse outcomes were comparable between patients with GDM based on WHO-1999 criteria and patients newly included by WHO-2013 criteria. Conclusions: Implementing the new diagnostic criteria leads to a considerable increase of prevalence of GDM. The newly included patients were more frequently overweighed and delivered babies with a higher birth weight. The added diagnostic value of the fasting glucose threshold of the WHO-1999 criteria is very low compared to the 2-h post-OGTT threshold, supporting the use of a lower fasting glucose threshold value as advocated by the WHO-2013 criteria. Tweet: The new WHO-2013 criteria leads to a considerable increase of prevalence of GDM.