Abstract
To analyze the suitability of the ADA 2011 criteria for diagnosing gestational diabetes mellitus (GDM) in China by comparing the clinical characteristics, pregnancy outcomes, and medical expenditure between women with GDM and normal glucose tolerance (NGT), according to the American Diabetes Association (ADA) 2011 (IADPSG) criteria. We conducted a retrospective observational study involving 3265 women followed at the Affiliated Hospital of Jinan University (Guangzhou, China), from November 1, 2011, to October 31, 2017. Screening of GDM using ADA 2011 criteria with the 75g oral glucose tolerance test (OGTT) was more expensive and effective, and adopting the ADA 2011 criteria was associated with reduced risk of emergency caesarean section (p < 0.01) and having any one of the adverse fetal outcomes (p < 0.01), including neonatal anaemia, neonatal infection, neonatal encephalopathy, admission to neonatal intensive care unit, birth trauma, neonatal hypoglycaemia, and fetal death. Propensity-matched modelling confirmed the absence of a difference between women with and without GDM. Moreover, the mean total medical expenditure of the GDM women was ￥6750.8, ￥1544.1 more than their NGT counterparts (P < 0.01). Despite the increasing medical expenditure, screening at 24–28 gestational weeks under the ADA 2011 guidelines with the 2-h, 75g OGTT can improve long-term maternal and neonatal outcomes.
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