Diagnosis of gestational diabetes mellitus using the international association of the diabetes and pregnancy study groups criteria and adverse pregnancy outcomes among a cohort of Filipino women: An association analysis

ABSTRACT

Introduction@#Locally, there is no unified set of diagnostic criteria for gestational diabetes mellitus (GDM) and this can lead to potential confusion on the part of the physician and the patient as well. Moreover, whether the adoption of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) threshold values for GDM diagnosis among Filipino women is appropriate is still unclear. This study serves to give a clinically important insight whether utilizing the abovementioned diagnostic criteria is appropriate in the local setting or not. The study aims to determine the association of the threshold values set up by the IADPSG to diagnose GDM with adverse pregnancy outcomes among a cohort of Filipino women.@*Methods@#A retrospective analysis of medical files of the women diagnosed with GDM using the IADPSG criteria from January 2013 to March 2016 was done. The results of seventyfive gram oral glucose tolerance test (75-g OGTT) were recorded. The association between each IADPSG threshold values (fasting blood glucose of ≥92 mg/dL, one-hour post glucose load of ≥180 mg/dL, two-hour post glucose load of ≥153 mg/dL) used to define GDM and maternal and perinatal outcomes were determined. @*Results@#One hundred twenty women with GDM were included in the analysis. Each of IADPSG-defined cut-off values was not significantly associated with increased likelihood of having adverse maternal outcomes namely hypertensive disorders of pregnancy, miscarriage, primary cesarean section, operative vaginal delivery, and maternal death. Similarly, the likelihood of perinatal outcomes namely macrosomia, perinatal death, prematurity, birth injuries, congenital anomalies, neonatal hypoglycemia, jaundice, low APGAR score, acute respiratory distress syndrome, and infection were not significantly higher even if these cut-off values were met. Of note, high odds ratio was noted for neonatal hypoglycemia at FBS >92 mg/dL and <92 mg/dL and the low Apgar Score in first minute at >153 mg/dL and <153 mg/dL even though they were statistically not significant. @*Conclusion@#We did not find a statistically significant positive association between IADPSG threshold values and specified adverse maternal and perinatal outcomes.