Endocrine Abstracts

Background: Gestational Diabetes Mellitus (GDM) is one of the most common illness of pregnancy. Despite its frequency, there’s no worldwide accepted screening criteria for GDM. In 2011, Carpenter and Coustan (CC) screening (50-g glucose challenge test (GCT) followed by 100-g glucose tolerance test (OGTT) if GCT screen was positive) was abandoned and began the implementation of the screening of the International Association of Diabetes and Pregnancy Study Group (IADPSG) 2010 (75-g OGTT).

Aims: Asses and compare perinatal outcomes of these two screening criteria.

Materials and methods: We undertook a retrospective study, of gestacional diabetes followed on Endocrinology department. Two groups were constituted: CC (followed in 2009 and 2010) and IADPSG (followed in 2014 and 2015). All patients were treated with nutrition and exercise. When target glucose levels were not met, insulin was initiated, no oral antidiabetic agents were used. Analysed data included birthweight, premature delivery, macrosomia, mode of delivery, maternal parity, body mass index (BMI) and insulin treatment.

Results: In 2009 and 2010, of 4705 childbirths in the hospital, 259 (5.5%) women met the CC criteria, of which 134 were included in this study. In 2014 and 2015, of 3496 childbirths in the hospital, 348 (9.9%) women met the IADPSG criteria, of which 221 were included in this study. Those with GDM per IADPSG criteria had more insulin treatment (46.6 vs 23.1%; P<0.0001), fewer large for gestacional age fetus (3.6 vs 9.0%, P=0.038) and less premature delivery (1.4 vs 5.2%, P=0.033).

Conclusions: Although the application of the IADPSG criteria increased the number of women diagnosed with GDM, there was an increase in insulin treatment, and an overall better newborn outcomes. This could mean that the IADPSG criteria identified a group of women with a increased risk of perinatal outcomes that were not recognized by the CC screening.