ABSTRACT
Background@#Evidence supporting various diagnostic criteria for diagnose gestational diabetes mellitus (GDM) are consensus-based, needs for additional evidence related to outcomes. Therefore, the aim of this systematic-review and meta-analysis was to assess the impact of different GDM diagnostic-criteria on the risk of adverse-neonatal-outcomes. @*Methods@#Electronic databases including Scopus, PubMed, and Web of Sciences were searched to retrieve English original, population-based studies with the universal GDM screening approach, up to January-2020. GDM diagnostic criteria were classified in seven groups and International Association of the Diabetes and Pregnancy Study Groups (IADPSG) was considered as reference one. We used the Mantel–Haenszel method to calculate the pooled odds of events. The possibility of publication bias was examined by Begg’s test. @*Results@#A total of 55 population-based studies consisting of 1,604,391 pregnant women with GDM and 7,770,855 non-GDM counterparts were included. Results showed that in all diagnostic-criteria subgroups, the risk of adverse neonatal outcomes including macrosomia, hyperbilirubinemia, respiratory distress syndrome, neonatal hypoglycemia, neonatal intensive care unit admission, preterm birth, and birth-trauma were significantly higher than the non-GDM counterparts were significantly higher than non-GDM counterparts. Meta-regression analysis revealed that the magnitude of neonatal risks in all diagnostic-criteria subgroups are similar. @*Conclusion@#Our results showed that the risk of adverse-neonatal-outcome increased among women with GDM, but the magnitude of risk was not different among those women who were diagnosed through more or less intensive strategies. These findings may help health-care-providers and policy-makers to select the most cost-effective approach for the screening of GDM among pregnant women.
ABSTRACT
Context: reproductive domains of the Tehran lipid and glucose study [TLGS] are unique in that they provide reliable information on reproduction of an urban population ofWest Asia. The aim of this review is to present the most important reproductive findings of TLGS
Evidence Acquisition: this review is summarizing all articles published in the context of reproductive aspects of TLGS results over the 20-year follow-up. A comprehensive databases search was conducted in PubMed [including Medline], Web of Science and Scopus for retrieving articles on the reproductive histories in context of the TLGS
Results: the mean [SD] age at menarche and menopause was 13 [1.2] and 49.6 [4.5] years respectively. While pills were the most commonly used modern methods at the initiation of TLGS, the prevalence of condoms rose sharply and significantly over the follow up duration. Among women with history of gestational diabetes, the risk of diabetes and dyslipidemia progression were 2.44 and 1.2 fold higher than others. Prevalences of PCOS and idiopathic hirsutism among reproductive age participants of TLGS were 8.5% [95% CI: 6.8% - 10.2%] and 13.0% [95% CI: 10.9% - 15.1%], respectively. Trend of cardio-metabolic risk factors among women with PCOS showed that there were no statistically significant differences between mean changes of each cardio metabolic variables between PCOS and healthy women; PCOS status also significantly associated with increased hazard of diabetes and prediabetes among women aged younger than 40 years [HR: 4.9; 95% CI: 2.5 - 9.3, P value < 0.001]] and [HR: 1.7; 95% CI: 1.1 - 2.6], P value < 0.005], respectively
Conclusions: the population based nature of TLGS provides a unique opportunity for valid assessment of reproductive issues, the results of which could provide new information for modification of existing guidelines
ABSTRACT
Gestational diabetes mellitus [GDM] is common problem during pregnancy. Diagnostic criteria of this problem are based on foreign population. Because of differences in racial, cultural, and nutritional characteristics, we need to determine these criteria are suitable for Iranian population. To determine whether different diagnostic criteria of gestational diabetes mellitus [GDM] are suitable for Iranian population. Prospective study was performed on 617 pregnant women. 1804 subjects referred for 50 g glucose challenge test [GCT] between 24[th] and 28[th] weeks of gestation. 617 women with abnormal GCT [blood glucose >/= 130 mg/dl] underwent 100-g 3-h oral glucose tolerance test [OGTT]. The results were classified by three diagnostic criteria: new "Iranian" diagnostic criteria based on the results from the 100-g 3-h OGTT performed in healthy participating women; the Carpenter and Coustan [CC] criteria; and the National Diabetes Data Group [NDDG] criteria. Obstetric and neonatal outcomes were recorded. With 89% as the statistical cutoff value for the 100-g 3-h OGTT, the new diagnostic criteria were 92, 179, 153, and 121 mg/dL at 0, 60, 120, and 180 min. The K value was 0.945 for the new criteria vs. the CC criteria and 0.657 for the new criteria vs. the NDDG criteria [p<0.001]. In women with GDM, the incidence rates of adverse outcomes by the new and CC criteria were similar, but higher than NDDG criteria [p<0.05]. Carpenter and Coustan criteria are applicable to Iranian pregnant women for diagnosis of GDM