Objective: To investigate the relationship between gestational hyperglycemia and adverse pregnancy outcomes and find out the optimum diagnostic criteria of gestational diabetes mellitus in China.
Methods: A retrospective population-based study of 14 593 pregnant women, who delivered between Jan.2005 and Dec.2009 and accepted the gestational diabetes mellitus (GDM) screening and diagnosis was performed. The prevalence of gestational hyperglycemia according to different criteria was calculated, and the incidence of adverse pregnant outcomes relation to gestational hyperglycemia according to different criteria was analyzed.
Results: (1) According to National Diabetes Data Group (NDDG) criteria and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, the prevalence of gestational hyperglycemia that intervention required was 8.9% (1293/14 593) and 14.7% (2138/14 593) respectively; the prevalence of gestational hyperglycemia differed significantly between NDDG and IADPSG criteria (P < 0.05). (2) The prevalence of macrosomia, large for gestational ages (LGA), cesarean section, preterm birth and neonatal hypoglycemia etc would increase in gestational glucose metabolic disorders according to any criteria. The prevalence of the complications in gestational hyperglycemia according to NDDG criteria, IADPSG criteria and the patients with normal glucose metabolism is as follows, macrosomia: 8.4% (108/1293), 11.3% (241/2138) and 6.7% (835/12 403); LGA: 9.7% (125/1293), 11.7% (250/2138) and 5.5% (687/12 403); cesarean section: 59.0% (763/1293), 60.4% (1291/2138) and 51.6% (6397/12 403); preterm birth: 11.4% (147/1293), 9.5% (203/2138) and 6.3% (777/12 403); neonatal hypoglycemia: 2.6% (33/1293), 2.2% (46/2138) and 0.7% (89/12 403).(3) About 71.3% (922/1293) of the gestational hyperglycemia according to NDDG criteria could be well control only by diet control.
Conclusion: The prevalence of perinatal complications would increase in gestational hyperglycemia that achieved IADPSG criteria without intervention, so IADPSG criteria is reasonable in China.