Perinatal Outcomes in Mexican Women with Untreated Mild Gestational Diabetes Mellitus Diagnosed by the International Association of Diabetes and Pregnancy Study Groups Criteria
Authors Martínez-Cruz N, Rapisarda AMC, Soriano-Ortega KP, Arce-Sánchez L, Cianci A, Ortega-Gonzalez C, Torres-Herrera U, Espino-Y-Sosa S, Estrada-Gutierrez G, Montoya-Estrada A, Romo-Yañez J, Reyes-Muñoz E
Received 3 September 2019
Accepted for publication 13 November 2019
Published 16 December 2019 Volume 2019:12 Pages 2667—2674
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Antonio Brunetti
Nayeli Martínez-Cruz,1 Agnese Maria Chiara Rapisarda,2 Karla Patricia Soriano-Ortega,3 Lidia Arce-Sánchez,1 Antonio Cianci,2 Carlos Ortega-Gonzalez,1 Ursula Torres-Herrera,1 Salvador Espino-Y-Sosa,3 Guadalupe Estrada-Gutierrez,4 Araceli Montoya-Estrada,5 José Romo-Yañez,5 Enrique Reyes-Muñoz5
1Department of Endocrinology, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Mexico City, México; 2Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy; 3Division of Clinical Research, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Mexico City, México; 4Direction of Research, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Mexico City, México; 5Department of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Mexico City, México
Correspondence: Enrique Reyes-Muñoz
Department of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800 Lomas Virreyes, Miguel, Hidalgo 11000, Mexico City Mexico
Tel +52 5555209900 Ext 307
Purpose: To compare the risk of adverse perinatal outcomes (APO) between pregnant women with mild gestational diabetes mellitus (GDM) diagnosed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, on no specific treatment, versus pregnant women without GDM.
Patients and Methods: A retrospective cohort study of pregnant women referred to the Instituto Nacional de Perinatología, in Mexico City, for prenatal care and delivery. Eligibility criteria were singleton pregnancy, age >18 years, gestational age 20–28 weeks, and no history of pre-gestational diabetes. The study population was divided into two groups: Group 1, comprising women with mild GDM defined by one abnormal glucose value at the oral glucose tolerance test (OGTT) according to IADPSG criteria [fasting: 5.1–5.2 mmol/L (92–94 mg/dL) or 2h 8.5–8.56 mmol/L (153–154 mg/dL)], who did not receive specific treatment for GDM, and Group 2, comprising women without GDM, matched for maternal age and pre-gestational body mass index (BMI). Women with two or more abnormal OGTT values, pre-gestational diabetes, any chronic disease, or multiple pregnancies were excluded.
Results: As many as 282 women were included in each group. There were no significant differences in basal characteristics between groups. APO analysis showed that newborn weight was significantly higher in Group 1 (3042.4±499g) vs Group 2 (2910±565g) p=0.003; conversely, the incidence of large for gestational age (LGA) and macrosomic neonates was similar in both groups (6 vs 5.7% and 2.1 vs 2.2%, respectively). There were no differences in rates of preeclampsia and gestational hypertension, cesarean and preterm delivery, or premature rupture of membranes. A sub-analysis by maternal pre-gestational BMI showed that LGA incidence was significantly higher among babies born to women with pre-gestational BMI ≥30 kg/m2 in both groups.
Conclusion: The risk of APO was similar among Mexican women with mild untreated GDM diagnosed by IADPSG criteria, compared to pregnant women without GDM. Pre-gestational BMI was an independent risk factor for LGA.
Keywords: gestational diabetes, large for gestational age, IADPSG, hyperglycemia, pregnancy
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