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Local versus international criteria in predicting gestational diabetes mellitus-related pregnancy outcomes / Philippine Journal of Obstetrics and Gynecology
Philippine Journal of Obstetrics and Gynecology ; : 33-42, 2014.
Article in English | WPRIM | ID: wpr-633583
ABSTRACT

OBJECTIVE:

To evaluate the Philippine Obstetrical and Gynecological Society Clinical Practice Guidelines (POGS-CPG) and the International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria for gestational diabetes mellitus (GDM) against pregnancy outcomes.

METHODS:

This is a randomized controlled trial which enlisted patients attending the Out-patient clinic of our institution. All women included in the study were requested to take a 2-hour 75-gram oral glucose tolerance test (OGTT) between estimated 24th and 28th gestational weeks. In order to diagnose GDM, POGS-CPG consensus required a fasting plasma glucose of >92 mg/dl (5.1 mmol/L) or a 2-hour post-glucose load of >140 mg/dl (7.8 mmol/ml) while lADPSG criteria required 92 mg/dL (5.1 mmol/L) for fasting plasma glucose, 180 mg/dL (10 mmol/L)1-hour post-glucose load, or 153 mg/dL (8.5 mmol/L) 2-hour post-glucose load. Only 1 abnormal value on the OGTT is needed on both criteria to diagnose GDM. Women with diabetes antedating pregnancy were excluded in this study. Based on the 75-g OGTT result, the patients were divided into 4 groups and were followed through delivery. Pregnancy out-comes of the 4 groups were then compared.

RESULTS:

Among the 389 patients studied, POGS-CPG group had a GDM prevalence rate of 29% whereas the IADPSG group had 16%. Trends have shown that in patients diagnosed with GDM under IADSGP and POGS criteria, no significant differences in the birth-weight status (p=0.156), mode of delivery (p=1.000), indication of cesarean section (p=1.000), and other complications (p=1.000) were noted. The 75 g OGTT values of patients in both groups were not significant predictors of APGAR scores. However, the 1-hour post-glucose load value was shown to be a significantpredictor of birth weight. Yet, the regression models of FBS parameters in predicting APGAR scores and birth weight were still weak.

CONCLUSION:

There was no significant difference noted between the IADPSG group versus the POGS-CPG group in terms of maternal neonatal outcome.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Pregnancy in Diabetics / Birth Weight / Blood Glucose / Pregnancy Outcome / Cesarean Section / Diabetes, Gestational / Glucose / Glucose Tolerance Test Type of study: Controlled clinical trial / Practice guideline / Prognostic study Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Philippine Journal of Obstetrics and Gynecology Year: 2014 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pregnancy in Diabetics / Birth Weight / Blood Glucose / Pregnancy Outcome / Cesarean Section / Diabetes, Gestational / Glucose / Glucose Tolerance Test Type of study: Controlled clinical trial / Practice guideline / Prognostic study Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Philippine Journal of Obstetrics and Gynecology Year: 2014 Type: Article