Impact of new international association of diabetes in pregnancy study group criteria for diagnosis of gestational diabetes on pregnancy outcome at a tertiary care hospital setting in southern india

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Journal of SAFOG


Aim: To find the correlation of maternal and perinatal outcome with a single abnormal oral glucose tolerance test (OGTT) value and with at least two abnormal values, in women with gestational diabetes diagnosed as per International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria. Materials and methods: This was a prospective observational study. Women diagnosed with gestational diabetes as per IADPSG criteria were divided into four groups with a single abnormal value (fasting/one hour/two hour) and at least two abnormal values. Pregnancy outcomes were compared between the groups using Chi-squared test. Results: Among 392 women with gestational diabetes, 146 (37.2%), 44 (11.2%), 50 (12.8%) had fasting value, 1-hour value and 2-hour value abnormal, respectively, and 152 (38.8%) had at least two values abnormal. Women with risk factors for gestational diabetes had at least two abnormal values followed by the fasting abnormal group. Requirement of oral hypoglycemics and/or insulin was in 42/152 (27.6%) and 14/152 (9.2%), respectively, in the groups with at least two values deranged, 34/146 (23.3%) and 6/146 (4.1%) in the fasting abnormal group, which are higher compared to other groups (p = 0.01). Recurrent urinary infection (28%) and polyhydramnios/macrosomia (38%) were significantly in the group with at least two abnormal values. Preterm labor/PROM was more with groups with fasting hyperglycemia (37%) and 2nd hour glucose abnormality (36%). Conclusion: Though more than two abnormal GTT values and fasting hyperglycemia were higher in high risk women who also required antiglycemic medications, the maternal and perinatal outcome was not specifically associated with any of the abnormal GTT value individually. Clinical significance: The study may have a role in decision-making regarding the screening and diagnostic strategies of gestational diabetes to be adopted in the Indian setting.

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