Pregnancy Outcomes of Taiwanese Women with Gestational Diabetes Mellitus: A Comparison of Carpenter-Coustan and National Diabetes Data Group Criteria

Abstract

To evaluate the pregnancy outcome of pregnant women in whom the 100-g oral glucose tolerance test (OGTT) met the criteria of Carpenter and Coustan (C&C) but not those of the National Diabetes Data Group (NDDG) for diagnosis of gestational diabetes mellitus (GDM). The medical records of 10,990 singleton pregnancies, delivered at Cathay General Hospital, Taiwan, between 2001 and 2008, were reviewed retrospectively. All pregnant women followed the two-step diagnostic algorithm for GDM; that is, women with a positive (>or=140 mg/dL) 50-g glucose challenge test (GCT) underwent a 100-g OGTT at 24-28 weeks of gestation. The pregnancies were classified as follows: group 1, women without GDM; group 2, women with GDM meeting the C&C criteria but not the NDDG criteria; and group 3, women with GDM diagnosed by NDDG criteria. Of the pregnancies, 10,116 (92%), 489 (4.4%), and 385 (3.5%) were classified into groups 1, 2, and 3, respectively. Women with GDM by the C&C criteria but not by the NDDG criteria had an increase in macrosomia compared with women without GDM, 22 (4.5%) infants vs. 236 (2.3%) infants, respectively (p < 0.05); however, there were no associated adverse complications. If the C&C criteria were used, the incidence of GDM increased to 874 (7.9%) pregnancies. GDM as defined by either NDDG or C&C criteria identified pregnancies complicated by macrosomia, cesarean section, and gestational hypertension compared with the healthy population (p < 0.05). In a Taiwanese population, using C&C criteria has no added advantages over using NDDG criteria.