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      Maternal and Neonatal Morbidity for Women Who Would Be Added to the Diagnosis of GDM Using IADPSG Criteria: A Secondary Analysis of the Hyperglycemia and Adverse Pregnancy Outcome Study

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          Abstract

          OBJECTIVE

          To assess the frequency of adverse outcomes for women who are diagnosed with gestational diabetes mellitus (GDM) by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria using data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study.

          RESEARCH DESIGN AND METHODS

          This is a secondary analysis from the North American HAPO study centers. Glucose measurements from a 75-g oral glucose tolerance test were used to group participants into three nonoverlapping categories: GDM based on Carpenter-Coustan (CC) criteria (also GDM based on IADPSG criteria), GDM diagnosed based on IADPSG criteria but not CC criteria, and no GDM. Newborn outcomes included birth weight, cord C-peptide, and newborn percentage fat above the 90th percentile; maternal outcomes included primary cesarean delivery and preeclampsia. Outcome frequencies were compared using multiple logistic regression, adjusting for predefined covariates.

          RESULTS

          Among 25,505 HAPO study participants, 6,159 blinded participants from North American centers were included. Of these, 81% had normal glucose testing, 4.2% had GDM based on CC criteria, and 14.3% had GDM based on IADPSG criteria but not CC criteria. Compared with women with no GDM, those diagnosed with GDM based on IADPSG criteria had adjusted odds ratios (95% CIs) for birth weight, cord C-peptide, and newborn percentage fat above the 90th percentile, as well as primary cesarean delivery and preeclampsia, of 1.87 (1.50–2.34), 2.00 (1.54–2.58), 1.73 (1.35–2.23), 1.31 (1.07–1.60), and 1.73 (1.32–2.27), respectively.

          CONCLUSIONS

          Women diagnosed with GDM based on IADPSG criteria had higher adverse outcome frequencies compared with women with no GDM. These data underscore the need for research to assess the effect of treatment to improve outcomes in such women.

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          Most cited references 13

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          Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus.

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            Practice Bulletin No. 137: Gestational diabetes mellitus.

              (2013)
            Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy. Debate continues to surround both the diagnosis and treatment of GDM despite several recent large-scale studies addressing these issues. The purpose of this document is to 1) provide a brief overview of the understanding of GDM, 2) provide management guidelines that have been validated by appropriately conducted clinical research, and 3) identify gaps in current knowledge toward which future research can be directed.
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              CRITERIA FOR THE ORAL GLUCOSE TOLERANCE TEST IN PREGNANCY.

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                Author and article information

                Journal
                Diabetes Care
                Diabetes Care
                diacare
                dcare
                Diabetes Care
                Diabetes Care
                American Diabetes Association
                0149-5992
                1935-5548
                December 2016
                15 September 2016
                : 39
                : 12
                : 2204-2210
                Affiliations
                1Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL
                2Northwestern University Feinberg School of Medicine, Chicago, IL
                3Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
                4Obstetric Medicine, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
                5Department of Pediatrics, Karolinska Institute, Stockholm, Sweden
                6Department of Obstetrics and Gynecology, Kaiser Foundation Hospital, Bellflower, CA
                7Department of Reproductive Biology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH
                Author notes
                Corresponding author: Thaddeus P. Waters, tedwatersmd@ 123456gmail.com .
                Article
                1194
                10.2337/dc16-1194
                5127228
                27634392
                © 2016 by the American Diabetes Association.

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 21, Pages: 4
                Product
                Funding
                Funded by: National Institute of Child Health and Human Development;
                Award ID: R-01-HD-34242
                Funded by: National Research Resources Grants;
                Award ID: M01-RR-00048
                Award ID: M01-RR-00080
                Funded by: National Institute of Diabetes, Digestive, and Kidney Diseases Grants;
                Award ID: R-01-34243
                Categories
                Clinical Care/Education/Nutrition/Psychosocial Research

                Endocrinology & Diabetes

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