Foetal and maternal outcomes in GDM diagnosed by IADPSG vs DIPSI criteria: A twin-centre study

Abstract

Objective

GDM has conventionally been defined as any degree of glucose intolerance with onset or first recognition during pregnancy warranting early recognition and management to improve maternal foetal outcomes. In India alone, GDM complicates almost four million pregnancies every year, depicting a large proportion of population at high risk for adverse perinatal morbidity and mortality. This makes it prudent to recommend universal screening for GDM for all women especially amongst SE Asian ethnicity.

Methods

This prospective, observational twin-centre study was carried out to observe maternal and foetal outcomes in two groups diagnosed as having GDM by two different criteria: 50 pregnant women were diagnosed with GDM by IADPSG criteria by performing a 75 g OGTT in a fasting state at 24–28 weeks. GDM was diagnosed if fasting ≥ 92 mg/dl or 1 h ≥ 180 mg/dl or 2 h ≥ 153 mg/dl — labelled as Group 1 — 50 pregnant women were diagnosed with GDM using DIPSI criteria by performing the single-step non-fasting 75 gm oral glucose challenge at 24–28 weeks. GDM was diagnosed with plasma glucose values ≥ 140 mg/dL at 2 h post glucose — labelled as Group 2 Both the groups were followed prospectively till the delivery of new born for assessment of immediate maternal and foetal outcomes.

Results

There was no statistical difference in foetal and maternal outcomes in groups.

Conclusions

Single-step DIPSI criteria can be used for screening and diagnosis of GDM for its simplicity, feasibility, economy and convenience. It has the potential to be applied to the entire obstetric population from India as well as the Indian subcontinent, meeting the needs of the developing world where the complicated three-step IADPSG can be challenging.