Prevalence, risk factors and perinatal outcomes of gestational diabetes in Mexican adolescents when applying diagnostic criteria from three different international guidelines

Abstract

To compare the prevalence, risk factors and perinatal outcomes of gestational diabetes mellitus (GDM) for Mexican adolescent population when applying different diagnostic criteria based on the 2-h 75-g oral glucose tolerance test, as established by three international guidelines. Comparative, observational, and retrospective study, which included pregnant women under 19 years, who underwent screening for GDM in our center. Data were obtained from the hospital’s electronic records and were analyzed using descriptive statistics. The X2 test was used to compare group proportions. Statistical significance was set at p ≤ 0.05. A total of 999 adolescents were screened for GDM. The observed prevalence was 3%, 14.4%, and 29.3% when using the Fifth International Workshop-Conference on Gestational Diabetes Mellitus (FIWC), National Institute for Health and Care Excellence (NICE-2015), and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, respectively. Of our sample, 42.5% presented at least one risk factor. An association was observed regarding the need for cesarean section in patients with GDM diagnosed through IADPSG criteria (OR = 1.35, p = 0.04). On the other hand, the use of the FIWC and NICE standards showed an association between GDM and obstetric hemorrhage (OR = 17.8, p = 0.000, and OR = 4.8, p = 0.01, respectively) and preeclampsia with severity criteria (OR = 5.1, p = 0.001, and OR = 2.4, P = 0.025, respectively). The prevalence of GDM in adolescents is high, and we can conclude that the prevalence varies based on which international diagnostic guideline is applied. While there is an association with adverse pregnancy outcomes such as hypertensive disorders of pregnancy, obstetric hemorrhage, and the need for cesarean section, this requires further evaluation.