National Diabetes Data Group vs Carpenter-Coustan criteria to diagnose gestational diabetes - 28/08/11
, Kim A. Boggess, MD a, Alison M. Stuebe, MD a, Michele Jonsson Funk, PhD b
Reprints: Erica K. Berggren, MD, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, CB #7570, Chapel Hill, NC 27599-7570Résumé |
Objective |
The objective of the study was to compare perinatal outcomes among women diagnosed with gestational diabetes by the National Diabetes Data Group (NDDG) criteria with women meeting only Carpenter-Coustan criteria.
Study Design |
This was a 14 year retrospective cohort. Women who screened positive with 1 hour glucose load 140 mg/dL or greater underwent a diagnostic 3 hour oral glucose tolerance test. We report adjusted prevalence ratios (aPRs) of perinatal outcome risk.
Results |
Of the 4659 screen-positive women with diagnostic testing, 1082 (3.3%, of 33,179) met NDDG criteria; 1542 (4.6%, of 33,179), or 460 more, met Carpenter-Coustan criteria. These 460 untreated women had greater risk of preeclampsia than women diagnosed by NDDG criteria (aPR, 1.70; 95% confidence interval [CI], 1.23–2.35). They had a greater risk of cesarean delivery (aPR, 1.16; 95% CI, 1.04–1.30) and infants greater than 4000 g (aPR, 1.25; 95% CI, 1.01–1.56) than women not meeting either diagnostic criteria.
Conclusion |
The 42.5% additional women diagnosed only by Carpenter-Coustan criteria are at greater risk for some adverse outcomes. Cost-effectiveness of a change remains to be determined.
Le texte complet de cet article est disponible en PDF.Key words : adverse perinatal outcome, diagnosis, gestational diabetes, gestational hypertension, preeclampsia
Plan
| E.K.B. is supported, in part, by National Institute of Child Health and Human Development Grant T32 HD30672-01 as a Clinical Training in Epidemiology and Clinical Trials fellow, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill. M.J.F. is supported by the Agency for Healthcare Research and Quality through a career development award (K02 HS17950) and has received salary support from GlaxoSmithKline through the University of North Carolina Center for Excellence in Pharmacoepidemiology and Public Health. K.A.B. and A.M.S. report no conflict of interest. |
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| Cite this article as: Berggren EK, Boggess KA, Stuebe AM, et al. National Diabetes Data Group vs Carpenter-Coustan criteria to diagnose gestational diabetes. Am J Obstet Gynecol 2011;205:253.e1-7. |
Vol 205 - N° 3
P. 253.e1-253.e7 - septembre 2011 Retour au numéro
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