Are the new IADPSG criteria for gestational diabetes useful in a country with a very high prevalence?

Gynecol Endocrinol. 2014 Sep;30(9):632-5. doi: 10.3109/09513590.2014.911278. Epub 2014 May 7.

Abstract

The International Association of Diabetes and Pregnancy Study Groups released new recommendations on screening methods and diagnostic criteria for gestational diabetes. The main objectives of the present study were to analyze characteristics of mothers who underwent the new screening test, and to assess the prevalence of gestational diabetes and related pregnancy complications such as the 5-minute Apgar score <7, in a urban maternity clinic in Djibouti. The effect of treating gestational diabetes was also evaluated. Totally, 231 mothers underwent the new screening test, and 106 were diagnosed as having gestational diabetes (45.9%). Mothers with gestational diabetes had an excess risk of low Apgar scores, even after adjustment for socio-economic and medical covariates, with an odds ratio of 6.34 (1.77-22.66), p value <0.005. Only 46.2% of mothers with gestational diabetes followed the recommendations regarding treatment. Among these patients, 18.6% of infants from untreated mothers had a 5-minute Apgar score <7, compared to 3.9% infants from treated mothers (p value = 0.017). After adjustment, untreated mothers still had a high excess risk of low Apgar scores, although non-significant, with an odds ratio of 4.67 (0.78-27.87), p value = 0.09. In conclusion, gestational diabetes is highly prevalent in Djibouti and is related to low Apgar scores.

Keywords: Apgar score; IADPSG criteria; gestational diabetes mellitus; pregnancy; screening test.

MeSH terms

  • Adult
  • Apgar Score*
  • Diabetes, Gestational / diagnosis*
  • Diabetes, Gestational / epidemiology
  • Djibouti / epidemiology
  • Female
  • Humans
  • Infant, Newborn
  • Mass Screening*
  • Practice Guidelines as Topic
  • Pregnancy
  • Prevalence