In January 2015, the diagnostic criteria for gestational diabetes mellitus changed, with the goal of increasing the sensitivity of diagnosis and improving overall glycaemic control, thereby reducing the numbers of adverse pregnancy outcomes associated with this condition. With any change in guidelines, it is imperative to assess the effectiveness of their implementation in terms of achieving outcomes, and to further identify areas for change and improvement.
A retrospective audit was conducted at Mackay Base Hospital to compare maternal and neonatal outcomes before and after the diagnostic guidelines were introduced. Data was collected via chart reviews, for a six month time period prior to January 2015, and a six month period after the introduction of new diagnostic guidelines. Data collected included demographic information, foetal outcomes, maternal outcomes and treatments used for those with gestational diabetes.
Preliminary data analysis has revealed a significant increase in the number of diagnoses of gestational diabetes, and an increase in the use of pharmacological treatments for gestational diabetes. However, the rates of adverse neonatal outcomes associated with gestational diabetes including macrosomia and shoulder dystocia have been similar pre and post the change in guidelines.
Based on the results of this study, the change in diagnostic criteria have not significantly improved neonatal or maternal outcomes in the overall patient cohort, although there has been an increase in the number of diagnoses of gestational diabetes and in interventional measures.