International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy

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doi:10.2337/dc09-1848

Cited by 3,634 publications

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“…Each pregnant woman received one test only, either 50‐g GCT followed by 100‐g OGTT or 75‐g OGTT. For 75‐g OGTT, women were diagnosed as GDM if they had plasma glucose above one of the following cut‐offs, including fasting plasma glucose ≥92 mg/dL, plasma glucose 1 h after OGTT ≥180 mg/dL and plasma glucose 2 h after OGTT ≥153 mg/dL13. For 50‐g GCT followed by 100‐g OGTT, GDM was screened by 50‐g GCT first.…”

Section: Methodsmentioning

confidence: 99%

“…In 2008, the Hyperglycemia and Adverse Pregnancy Outcome study found an association of maternal plasma glucose during 2‐h, 75‐g OGTT and adverse pregnancy outcomes 12. Based on the findings, the International Association of the Diabetes and Pregnancy Study Group (IADPSG) proposed a new diagnostic strategy using 75‐g OGTT13, which was adopted by the ADA in 201114. The 50‐g GCT is not included in the IADPSG strategy.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria

Nien

Kuo

et al. 2015

J of Diabetes Invest

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Aims/IntroductionThe International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria for gestational diabetes are associated with increased prevalence. However, it remains unknown if intervention for more women with gestational diabetes mellitus by the IADPSG criteria results in better pregnancy outcomes than adopting the Carpenter and Coustan (C&C) criteria in Asian populations.Materials and MethodsThis was a retrospective cohort study. A total of 1,840 women, 952 subjects by the IADPSG criteria and 888 subjects by the C&C criteria, who delivered singletons in 2011 in a single tertiary center, were included in the study. The same therapeutic interventions were offered to women with gestational diabetes mellitus by the two criteria. Maternal and neonatal outcomes were evaluated.ResultsAdopting the IADPSG criteria increased the prevalence of gestational diabetes mellitus diagnosis to 13.44%, compared with 2.59% by the C&C criteria. The diagnosis was made 3 weeks earlier by the IADPSG criteria (27 vs 30.5 weeks, P < 0.0001). Adopting the IADPSG criteria was associated with reduced risk of primary cesarean section (adjusted odds ratio 0.79, 95% confidence interval 0.63–0.998, P < 0.05) and having any one of the adverse fetal outcomes (adjusted odds ratio 0.79, 95% confidence interval 0.64–0.998, P < 0.05), including birthweight >90th percentile, jaundice, admission to neonatal intensive care unit, birth trauma, neonatal hypoglycemia and fetal death.ConclusionsAdopting the IADPSG criteria is associated with improved pregnancy outcomes, at the expense of increased prevalence of gestational diabetes mellitus diagnosis.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria

Nien

Kuo

et al. 2015

J of Diabetes Invest

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“…Women with capillary‐blood glucose levels ≥7.2 mmol/L after a 1‐h 50‐g glucose challenge underwent a 75‐g OGTT within a week, after an 8–12‐h overnight fast. Using the 2010 International Association of Diabetes and Pregnancy Study Groups criteria14, GDM was diagnosed when one or more of the following conditions equalled or exceeded the established thresholds on a 75‐g OGTT: FPG 5.1 mmol/L; 1‐h plasma glucose 10.0 mmol/L; and 2‐h plasma glucose 8.5 mmol/L. If all OGTT values were less than the aforementioned thresholds, the participant was defined as normal.…”

Section: Methodsmentioning

confidence: 99%

Association between glycemic control and birthweight with glycated albumin in Chinese women with gestational diabetes mellitus

Wang²,

Tao

et al. 2015

J of Diabetes Invest

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Aims/IntroductionTo assess glycated albumin (GA) as a potential glycemic index in managing gestational diabetes mellitus (GDM).Materials and MethodsEligible pregnant women were divided into the GDM group with abnormal result on a 75‐g oral glucose tolerance test (OGTT) and the control (normal) group. GA measurements, Pearson's correlation analysis, multiple logistic regression and receiver operating characteristic curve analysis were obtained at the follow‐up examination of participants in the two groups.ResultsA total of 2,118 women were assigned to the GDM group (n = 639) and control group (n = 1,479). The mean level of serum GA in GDM group was significantly greater than that in the control group at both 24–28 and 36–38 weeks of gestation (P < 0.05). The area under the receiver operating characteristic curve for GA defining good glycemic control in GDM was 0.874 (95% confidence interval 0.811–0.938). The cut‐off point for the GA levels derived from the receiver operating characteristic curve was 11.60%, which had sensitivity and specificity for detecting a poor glycemic status of 75.93% and 86.36%, respectively. The risk of birthweight ≥3,500 g and macrosomia increased significantly with GA levels ≥13.00% at 24–28 weeks and ≥12.00% at 36–38 weeks of gestation.ConclusionsGA might be an appropriate and conveniently measured index that can detect poor glycemic control and predict birthweights in GDM women.

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“…We also identified 70 specific situations guidelines published between 2002 and 2014. Of these, 91% were from the USA,25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59 UK60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76 and Canada 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88. The remaining were from Australia,89 Brazil,90 Mexico,91 Poland,92 Spain93 and Uruguay 94…”

Section: Resultsmentioning

confidence: 99%

Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care

Ábalos

Chamillard

Díaz

et al. 2015

BJOG

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BackgroundThe World Health Organization (WHO) is in the process of updating antenatal care (ANC) guidelines.ObjectivesTo map the existing clinical practice guidelines related to routine ANC for healthy women and to summarise all practices considered during routine ANC.Search strategyA systematic search in four databases for all clinical practice guidelines published after January 2000.Selection criteriaTwo researchers independently assessed the list of potentially eligible publications.Data collection and analysisInformation on scope of the guideline, type of practice, associated gestational age, recommendation type and the source of evidence were mapped.Main resultsOf 1866 references, we identified 85 guidelines focusing on the ANC period: 15 pertaining to routine ANC and 70 pertaining to specific situations. A total of 135 interventions from routine ANC guidelines were extracted, and categorised as clinical interventions (n = 80), screening/diagnostic procedures (n = 47) and health systems related (n = 8). Screening interventions, (syphilis, anaemia) were the most common practices. Within the 70 specific situation guidelines, 102 recommendations were identified. Overall, for 33 (out of 171) interventions there were conflicting recommendations provided by the different guidelines.ConclusionMapping the current guidelines including practices related to routine ANC informed the scoping phase for the WHO guideline for ANC. Our analysis indicates that guideline development processes may lead to different recommendations, due to context, evidence base or assessment of evidence. It would be useful for guideline developers to map and refer to other similar guidelines and, where relevant, explore the discrepancies in recommendations and others.Tweetable abstractWe identified existing ANC guidelines and mapped scope, practices, recommendations and source of evidence.

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International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy

Cited by 3,634 publications

References 49 publications

Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria

Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria

Association between glycemic control and birthweight with glycated albumin in Chinese women with gestational diabetes mellitus

Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care

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