Gestational diabetes mellitus among Nordic Caucasian women: Prevalence and risk factors according to WHO and simplified IADPSG criteria

Abstract

Background. Gestational diabetes mellitus (GDM) is associated with both maternal and offspring adverse effects. The World Health Organization (WHO) has recently adopted novel GDM criteria. The aim of this study was to evaluate the former WHO and a simplified version of the new International Association for Diabetes in Pregnancy Study Group (IADPSG) criteria as to prevalence of and risk factors for GDM in a Nordic Caucasian population. Methods. A 75 g oral glucose tolerance test was performed in 687 women at 18–22 and 32–36 pregnancy weeks. GDM was defined according to the WHO criteria as fasting plasma glucose ≥ 7.0 mmol/L and/or 2-hour plasma glucose ≥ 7.8 mmol/L and by a simplified version of the IADPSG criteria as either fasting glucose ≥ 5.1 mmol/L and/or 2-h plasma glucose ≥ 8.5 mmol/L. One-hour glucose values were not available and were thus not included in the diagnosis of GDM by IADPSG. Prevalence of GDM during pregnancy and risk factors for GDM at 18–22 weeks were studied in retrospect according to each of the two criteria. Results. The total prevalence of GDM during pregnancy was 6.1% (42/687) for the WHO criteria and 7.4% (51/687) for the simplified IADPSG criteria. High maternal age and short stature were independently associated with WHO GDM. Maternal age, fasting insulin and no regular exercise at 18–22 pregnancy weeks associated with simplified IADPSG GDM. Conclusions. Simplified IADPSG criteria moderately increase GDM prevalence compared with the WHO criteria. Risk factors for GDM differ with the diagnostic criteria used.

Key Words::

• GDM
• GDM diagnostic criteria
• GDM risk factors
• IADPSG criteria
• pregnancy-induced diabetes
• WHO criteria

Acknowledgements

The study was supported by the Norwegian Fund for Postgraduate Training in Physiotherapy, the Liaison Committee for Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology. The authors thank Kristin Rian for performing the insulin analyses, the physiotherapists Marit Lindland Ree, Wilma van de Veen, Karen Schei, Marte Sundby, Irene Hiim Torjusen and Henriette Tokvam Larsen and medical secretaries Elin Ørndahl Holthe and Heidi Larsen at the two hospitals for their efforts in performing this study with exercise classes and testing, as well as the women who participated in this study.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.