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dc.contributor.authorMeek, CL
dc.contributor.authorLewis, HB
dc.contributor.authorPatient, C
dc.contributor.authorMurphy, HR
dc.contributor.authorSimmons, D
dc.date.accessioned2020-12-21T01:31:43Z
dc.date.available2020-12-21T01:31:43Z
dc.date.issued2015-09-01
dc.identifier.citationMeek, C. L., Lewis, H. B., Patient, C., Murphy, H. R. & Simmons, D. (2015). Diagnosis of gestational diabetes mellitus: falling through the net. DIABETOLOGIA, 58 (9), pp.2003-2012. https://doi.org/10.1007/s00125-015-3647-z.
dc.identifier.issn0012-186X
dc.identifier.urihttp://hdl.handle.net/11343/256548
dc.description.abstractAIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM) is associated with increased risks to mother and child, but globally agreed diagnostic criteria remain elusive. Identification of women with GDM is important, as treatment reduces adverse outcomes such as perinatal death, shoulder dystocia and neonatal hypoglycaemia. Recently, the UK's National Institute for Health and Care Excellence (NICE) recommended new diagnostic thresholds for GDM which are different from the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria endorsed by the WHO. The study aim was to assess neonatal and obstetric outcomes among women who would test positive for the IADPSG criteria but negative for the NICE 2015 criteria. METHODS: Data from 25,543 consecutive singleton live births (2004-2008) were obtained retrospectively from hospital records. Women were screened with a random plasma glucose (RPG; 12-16 weeks) and a 50 g glucose challenge test (GCT; 26-28 weeks). If RPG >7.0 mmol/l, GCT >7.7 mmol/l or symptoms were present, a 75 g OGTT was offered (n = 3,848). RESULTS: In this study, GDM prevalence was 4.13% (NICE 2015) and 4.62% (IADPSG). Women who 'fell through the net', testing NICE-negative but IADPSG-positive (n = 387), had a higher risk of having a large-for-gestational-age (LGA) infant (birthweight >90th percentile for gestational age; adjusted OR [95% CI] 3.12 [2.44, 3.98]), Caesarean delivery (1.44 [1.15, 1.81]) and polyhydramnios (6.90 [3.94, 12.08]) compared with women with negative screening results and no OGTT (n = 21,695). LGA risk was highest among women with fasting plasma glucose 5.1-5.5 mmol/l (n = 167): the mean birthweight was 350 g above that of the reference population and 37.7% of infants were LGA. CONCLUSIONS/INTERPRETATION: The IADPSG criteria identify women at substantial risk of complications who would not be identified by the NICE 2015 criteria.
dc.languageEnglish
dc.publisherSPRINGER
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleDiagnosis of gestational diabetes mellitus: falling through the net
dc.typeJournal Article
dc.identifier.doi10.1007/s00125-015-3647-z
melbourne.affiliation.departmentRural Clinical School
melbourne.source.titleDiabetologia
melbourne.source.volume58
melbourne.source.issue9
melbourne.source.pages2003-2012
dc.rights.licenseCC BY
melbourne.elementsid1222985
melbourne.contributor.authorSimmons, David
dc.identifier.eissn1432-0428
melbourne.accessrightsOpen Access


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