University of Oulu

Koivunen S, Viljakainen M, Männistö T, Gissler M, Pouta A, Kaaja R, et al. (2020) Pregnancy outcomes according to the definition of gestational diabetes. PLoS ONE 15(3): e0229496. https://doi.org/10.1371/journal.pone.0229496

Pregnancy outcomes according to the definition of gestational diabetes

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Author: Koivunen, Sanna1,2; Viljakainen, Matti1,2; Männistö, Tuija3;
Organizations: 1PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and the University of Oulu, Finland
2Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland
3Northern Finland Laboratory Centre NordLab, Department of Clinical Chemistry and MRC Oulu, Oulu University Hospital and the University of Oulu, Oulu, Finland
4Information Department, National Institute for Health and Welfare, Helsinki, Finland and the Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
5Department of Government Services, National Institute of Health and Welfare, Helsinki, Finland
6University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland
7Department of General Practice, University of Helsinki and Helsinki University Hospital Folkhälsan Research Centre, Helsinki, Finland
8Department of Obstetrics and Gynaecology, Tampere University Hospital and University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Helsinki, Medical and Clinical Genetics. University of Helsinki and Helsinki University Hospital, Helsinki, Finland
9Institute for Molecular Medicine Finland, Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, Finland
10Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
11Children’s Hospital, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2020050825740
Language: English
Published: Public Library of Science, 2020
Publish Date: 2020-05-08
Description:

Abstract

Objective: To assess the frequency and perinatal outcomes of gestational diabetes mellitus (GDM) defined by the criteria according to the International Association of Diabetes in Pregnancy Study Group (IADPSG) and the National Institute for Health and Care Excellence (NICE) diagnostic criteria for GDM.

Design: A retrospective cohort study.

Setting: Six secondary and tertiary delivery hospitals in Finland in 2009.

Population: Pregnant women (N = 4,033) and their offspring.

Methods: We used data on comprehensive screening of pregnant women with a 2-h 75-g oral glucose tolerance test (OGTT), performed between gestational weeks 24 and 40. OGTT glucose concentrations were used to identify women who fulfilled IADPSG and NICE criteria. While cut-offs according to Finnish national criteria partly overlapped with both criteria, a subgroup of IADPSG- or NICE-positive GDM women remained undiagnosed by Finnish criteria and hence non-treated. They were analysed as subgroups and compared to controls who were negative with all cut-offs.

Main outcome measures: GDM prevalence, birth weight SD score (BWSDS), large for gestational age (LGA) and caesarean section (CS) rates.

Results: Among the 4,033 women screened for GDM, 1,249 (31.0%) and 529 (13.1%) had GDM according to the IADPSG and NICE criteria, respectively. The LGA rate was similar in both groups. Regardless of the diagnostic criteria, women with GDM had a higher risk of induced delivery and CSs than controls. In IADPSG-positive non-treated women, offspring’s BWSDS and CS rate were higher than in controls.

Conclusions: GDM prevalence was 2.4-fold higher according to the IADPSG compared with the NICE criteria but the LGA rate did not differ. BWSDS and CS rate were increased already with mild untreated hyperglycaemia.

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Series: PLoS one
ISSN: 1932-6203
ISSN-E: 1932-6203
ISSN-L: 1932-6203
Volume: 15
Issue: 3
Article number: e0229496
DOI: 10.1371/journal.pone.0229496
OADOI: https://oadoi.org/10.1371/journal.pone.0229496
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Subjects:
Funding: This work was supported by the Academy of Finland (Grants 127437, 129306, 130326, 134791, 263924 and 315690 to Eero Kajantie); the European Commission (Horizon 2020 award 733280) RECAP Research on Children and Adults born preterm to EK); the Finnish Foundation for Pediatric Research (to EK); the Juho Vainio Foundation (to EK and Marja Vääräsmäki); the Novo Nordisk Foundation (to EK and MV); The Signe and Ane Gyllenberg Foundation (to EK); the Sigrid Juselius Foundation (to EK); and the Yrjö Jahnsson Foundation (to EK and MV), Medical Research Center Oulu (Sanna Koivunen); National Graduate School of Clinical Investigation (SK); Pohjois-Suomen terveydenhuollon Tukisäätiö (SK) and The Finnish Medical Foundation (SK). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright information: © 2020 Koivunen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
  https://creativecommons.org/licenses/by/4.0/