Incidencia de la diabetes mellitus gestacional según distintos criterios diagnósticos en la zona suroeste de Madrid. Influencia del diagnóstico sobre los parámetros maternofetales

Abstract

BACKGROUND. In 1997, The Fourth International Workshop-Conference on Gestational Diabetes Mellitus (GDM) recommended the use of Carpenter and Coustan diagnostic criteria instead of those of Sullivan and Mahan used until then. The objective of this work was to study the incidence of GDM in the southeast Madrid area by applying both the classical and new criteria, as well as to determine whether patients diagnosed of GDM by the new criteria present a higher materno-fetal morbidity than treated GDM patients or non diabetic pregnant patients.Methods. Review of a cohort of 1,293 pregnant women from September 1998 to August 1999 who were screened for GDM. The annual cumulated incidence of GDM was estudied by using both diagnostic criteria and materno-fetal evolution of four groups of patients classified according to glucose intolerance degree. RESULTS. The annual cumulated incidence of GDM was 4.8% and 7.3% using the classical criteria and the new criteria, respectively. GDM patients fulfilling only the new criteria and not treated as such had children with a significantly higher birth-weight than the other groups, and a trend towards a higher percentage of macrosomies, instrumental deliveries and cesarean sections in such group was observed, although they were not statistically significant. CONCLUSIONS. The incidence of GDM in the southeast Madrid area was similar to that among other Caucasian populations and increased by 52% when the new diagnostic criteria were used. It is our opinion that a study with a larger number of patients should be conducted before the new diagnostic criteria are applied in our country.