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Poster session II Clinical obstetrics, diabetes, labor, medical-surgical-disease, physiology/endocrinology, prematurity: Abstracts 237 - 386| Volume 208, ISSUE 1, SUPPLEMENT , S114, January 01, 2013

249: Have the new diagnostic criteria for gestational diabetes mellitus (GDM) impacted on perinatal maternal and fetal outcomes?

      Objective

      The International Association of Diabetes and Pregnancy Study Group (IADPSG) recently adopted new criteria for the diagnosis of GDM based on the results of the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) trial. These criteria for diagnosis were adopted by our unit in 2011.
      The aim of our study was to determine the difference in perinatal outcomes in 3 separate groups and to provide information on these women who are now deemed to have gestational diabetes.
      The patients in Group 2 and 3 received treatment in a tertiary referral unit for the management of GDM.

      Study Design

      A prospective study of oral glucose tolerance tests (OGTTs) performed in a large tertiary referral hospital with a delivery rate of greater than 8,500 births per year. The presence of GDM and perinatal outcomes were compared in three groups. Group 1=Not GDM. Group 2 =GDM. Group 3= Additional women diagnosed GDM based on new criteria.

      Results

      1590 patients had OGTT results and complete data recorded in 2011.The number of women with GDM using the new criteria was increased by 26.4%. The extra women had an increased BMI at booking (p=0.001) but there was no increase in shoulder dystocia or pre-eclampsia. There was no difference in caesarean section rates (Table).
      Table
      Table thumbnail grr10

      Conclusion

      The new diagnostic criteria for GDM will result in an increased rate of diagnosis of GDM and therefore increased surveillance of these patients. However this treatment will not improve perinatal outcome, we may now be diagnosing and treating a group of women without sufficient evidence of clinical benefit.