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Please use this identifier to cite or link to this item: http://repositorio.ufba.br/ri/handle/ri/18107

Title: Gestational Diabetes Mellitus Diagnosed With a 2-h 75-g Oral Glucose Tolerance Test and Adverse Pregnancy Outcomes
Other Titles: Diabetes Care
Authors: Schmidt, Maria Inês
Duncan, Bruce Bartholow
Reichelt, Angela J.
Branchtein, Leandro
Matos, Maria C.
Forti, Adriana Costa e
Spichler, Ethel R.
Pousada, Judith Maria Dias Carreiro
Teixeira, Margareth M.
Yamashita, Tsuyoshi
Keywords: Diabetes Mellitus;Glucose;Diabetes, Gestational;Hypertension
Issue Date: 2001
Abstract: OBJECTIVE—To evaluate American Diabetes Association (ADA) and World Health Organization (WHO) diagnostic criteria for gestational diabetes mellitus (GDM) against pregnancy outcomes. RESEARCH DESIGN AND METHODS—This cohort study consecutively enrolled Brazilian adult women attending general prenatal clinics. All women were requested to undertake a standardized 2-h 75-g oral glucose tolerance test (OGTT) between their estimated 24th and 28th gestational weeks and were then followed to delivery. New ADA criteria for GDM require two plasma glucose values ≥5.3 mmol/l (fasting), ≥10 mmol/l (1 h), and ≥8.6 mmol/l (2 h). WHO criteria require a plasma glucose ≥7.0 mmol/l (fasting) or ≥7.8 mmol/l (2 h). Individuals with hyperglycemia indicative of diabetes outside of pregnancy were excluded. RESULTS—Among the 4,977 women studied, 2.4% (95% CI 2.0–2.9) presented with GDM by ADA criteria and 7.2% (6.5–7.9) by WHO criteria. After adjustment for the effects of age, obesity, and other risk factors, GDM by ADA criteria predicted an increased risk of macrosomia (RR 1.29, 95% CI 0.73–2.18), preeclampsia (2.28, 1.22–4.16), and perinatal death (3.10, 1.42–6.47). Similarly, GDM by WHO criteria predicted increased risk for macrosomia (1.45, 1.06–1.95), preeclampsia (1.94, 1.22–3.03), and perinatal death (1.59, 0.86–2.90). Of women positive by WHO criteria, 260 (73%) were negative by ADA criteria. Conversely, 22 (18%) women positive by ADA criteria were negative by WHO criteria. CONCLUSIONS—GDM based on a 2-h 75-g OGTT defined by either WHO or ADA criteria predicts adverse pregnancy outcomes.
Description: Texto completo: acesso restrito. p. 1151-1155
URI: http://repositorio.ufba.br/ri/handle/ri/18107
ISSN: 0149-5992
Appears in Collections:Artigos Publicados em Periódicos (Medicina)

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