Pregnancy outcomes of Taiwanese women with gestational diabetes mellitus: a comparison of Carpenter-Coustan and National Diabetes Data Group criteria.

ABSTRACT

AIMS: To evaluate the pregnancy outcome of pregnant women in whom the 100-g oral glucose tolerance test (OGTT) met the criteria of Carpenter and Coustan (C&C) but not those of the National Diabetes Data Group (NDDG) for diagnosis of gestational diabetes mellitus (GDM). METHODS: The medical records of 10,990 singleton pregnancies, delivered at Cathay General Hospital, Taiwan, between 2001 and 2008, were reviewed retrospectively. All pregnant women followed the two-step diagnostic algorithm for GDM; that is, women with a positive (>or=140 mg/dL) 50-g glucose challenge test (GCT) underwent a 100-g OGTT at 24-28 weeks of gestation. The pregnancies were classified as follows group 1, women without GDM; group 2, women with GDM meeting the C&C criteria but not the NDDG criteria; and group 3, women with GDM diagnosed by NDDG criteria. RESULTS: Of the pregnancies, 10,116 (92%), 489 (4.4%), and 385 (3.5%) were classified into groups 1, 2, and 3, respectively. Women with GDM by the C&C criteria but not by the NDDG criteria had an increase in macrosomia compared with women without GDM, 22 (4.5%) infants vs. 236 (2.3%) infants, respectively (p < 0.05); however, there were no associated adverse complications. If the C&C criteria were used, the incidence of GDM increased to 874 (7.9%) pregnancies. GDM as defined by either NDDG or C&C criteria identified pregnancies complicated by macrosomia, cesarean section, and gestational hypertension compared with the healthy population (p < 0.05). CONCLUSIONS: In a Taiwanese population, using C&C criteria has no added advantages over using NDDG criteria.