Poster Presentation Australasian Diabetes in Pregnancy Society Annual Scientific Meeting 2016

Did the revision in the criteria for diagnosis of gestational diabetes change neonatal outcomes? (#110)

Hui Yi Ng 1 , Rowena Hockings 2 , Jennifer Budd 3 , Alexia Pape 1
  1. Endocrinology, Wollongong Hospital, Wollongong, NSW, Australia
  2. Research Central, Wollongong Hospital, Wollongong, NSW, Australia
  3. Maternity Services, Wollongong Hospital, Wollongong, NSW, Australia

Background

The purpose of this audit was to determine if the rate of large for gestational age neonates (LGA) and foetal adverse outcomes had improved after implementation of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for the diagnosis of gestational diabetes (GDM)1 in 2011 in Wollongong Public Hospital.

 

Methods

De-identified data from the midwife database for all births in Wollongong Public Hospital was obtained from 2008 to 2015. Patients in 2011, patients without diabetes and with pre-existing diabetes were excluded. The patients from 2008 to 2010 were classified as “Group 1”, and from 2012 to 2015 as “Group 2”.

 

Results

There was a significantly increased rate of GDM diagnoses in Group 2 (n=1958, 20.7%) compared to Group 1 there were (n=457, 6.5%) (p < 0.001). The median maternal body mass index (BMI) was significantly higher in Group 2 (28 kg/m2) than in Group 1 (26.7kg/m2) (p=0.002). There was also a greater need for insulin treatment in Group 2 (n=624, 31.7% vs. n= 115, 25.1%) (p=0.005).

 

The rate of LGA neonates was significantly reduced in Group 2 (n=269, 13.7%) compared to Group 1 (n=77, 16.8%) (p=0.027), however the rate of special care nursery admissions was greater in Group 2 (n=443, 22.6% vs. n=60, 13%) (p<0.001).

 

There was no significant difference in the mode of birth (p=0.067), neonatal hypoglycaemia (p=0.087) and respiratory distress (p=0.430) between the two groups.

 

Conclusions

Since the change in GDM diagnostic criteria, there was double the amount of women diagnosed with GDM than previously published data in 20112, possibly relating to a significant increase in median BMI. There were more women requiring insulin treatment. There was a significant decrease in the number of LGA infants. We could not find a significant change in other neonatal outcomes.

  1. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycaemia in pregnancy. Diabetes Care, Vol 33, Number 3, March 2010.
  2. Moses RG, SanGil F, Morris G, Petocz P, Garg D. Impact of the potential new diagnostic criteria on the prevalence of gestational diabetes meillitus in Australia. Med J Aust 2011; 194:338-340.