Potential impact of American Diabetes Association (2000) criteria for diagnosis of gestational diabetes mellitus in Spain

Ricart, Wifredo; López, José López; Mozas, Juan; Pericot, A.; Sancho, M.; González, Nieves Luisa González; Balsells, Montserrat; Luna, Rafaella Cristhine Pordeus; Cortázar, Alicia; Navarro, Piedad; Ramírez, O.; Flández, B.; Pallardo, LF; Hernández, Antonio; Ampudia, Jeanette; Fernández-Real, José Manuel; Corcoy, Rosa; thresholds, Coustan Gdm

doi:10.1007/s00125-005-1756-9

Cited by 107 publications

(77 citation statements)

References 39 publications

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“…Glucose intolerance or obesity was not significantly associated with PIH or macrosomia in an Australian cohort [22]. The present study, partially reported in [15], identifies pregestational BMI and abnormal glucose tolerance categories as independent predictors of perinatal outcome with similar ORs for abnormal glucose tolerance categories and upper BMI quartiles. In addition, it is important to note that upper BMI quartiles in this study do not represent extreme obesity; in fact, the cut-off for the fourth quartile is close to that of overweight.…”

Section: Discussionsupporting

confidence: 53%

“…All variables for which significance is provided are included in the model. Predictive models have been published in [15]. This table adds information on attributable and prevented fractions in the population gories for the prediction (and potential prevention) of macrosomia.…”

Section: Discussionmentioning

confidence: 99%

“…This prospective study was conducted in 16 general hospitals of the Spanish National Health Service in 2002 and the research design and methods are reported in [15]. The research was performed in accordance with the Declaration of Helsinki as revised in 2000 and informed consent was obtained from patients where appropriate.…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

“…Four glucose tolerance groups were defined [15,20]: women with GDM according to NDDG criteria receiving usual care (NDDG GDM), and three untreated groups, representing a gradient of carbohydrate tolerance. Negative screenees had a glucose value below 7.8 mmol/l after a 50 g glucose oral challenge (GCT).…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

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Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia

et al. 2005

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Aims/hypothesis: We evaluated diabetes-related pregnancy outcomes in a cohort of Spanish women in relation to their glucose tolerance status, prepregnancy BMI and other predictive variables. Methods: The present paper is part of a prospective study to evaluate the impact of American Diabetes Association (2000) criteria in the Spanish population. A total of 9,270 pregnant women were studied and categorised as follows according to prepregnancy BMI quartiles and glucose tolerance status: (1) negative screenees; (2) false-positive screenees; (3) gestational diabetes mellitus (GDM) according to American Diabetes Association criteria only; and (4) GDM according to National Diabetes Data Group criteria (NDDG). We evaluated fetal macrosomia, Caesarean section and seven secondary outcomes as diabetes-related pregnancy outcomes. The population-attributable and population-prevented fractions of predictor variables were calculated after binary logistic regression analysis with multiple predictors. Results: Both prepregnancy BMI and abnormal glucose tolerance categories were independent predictors of pregnancy outcomes. The upper quartile of BMI accounted for 23% of macrosomia, 9.4% of Caesarean section, 50% of pregnancy-induced hypertension and 17.6% of large-for-gestational-age newborns. In contrast, NDDG GDM accounted for 3.8% of macrosomia, 9.1% of pregnancy-induced hypertension and 3.4% of preterm births. Conclusions/ interpretation: In terms of population impact, prepregnancy maternal BMI exhibits a much stronger influence than abnormal blood glucose tolerance on macrosomia, Caesarean section, pregnancy-induced hypertension and large-for-gestational-age newborns.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Subjects Materials and Methodsmentioning

confidence: 99%

Section: Subjects Materials and Methodsmentioning

confidence: 99%

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Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia

et al. 2005

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“…Similar to the population-based studies, in the hospital-based studies the prevalence of GDM varied depending upon the diagnostic criteria employed in the study, whether the study was retrospective or prospective as well as the country of residence, ethnicity and racial group of the study participants. Three of the hospital-based studies directly compare GDM prevalence rates based on NDDG and C & C criteria (86)(87)(88). In these three studies, NDDG rates range from 3.2% in a study conducted in Mexico(86) to 8.8% in a study conducted in Spain(87) with corresponding C & C rates ranging from 4.1% to 11.6%(86-88).…”

Section: Hospital-based Studiesmentioning

confidence: 99%