Increasing prevalence of GDM when implementing the IADPSG criteria
Gestational Diabetes Mellitus is a condition that is marked by varying degrees of glucose intolerance during pregnancy.
Various short-term and long-term complications associated with gestational diabetes mellitus include pre-eclampsia, metabolic syndrome and glucose intolerance.
The International Association of Diabetes and Pregnancy Study Groups (IADPSG) consensus panel outlined new diagnostic criteria for GDM and thereby the World Health Organization adopted them. They defined GDM : a 75 g OGTT at an adjusted threshold of 1.75 times odds ratio for adverse pregnancy outcomes with glucose concentration cut-offs of fasting > or = 5.1, 1-hour > or = 10and/or 2-hour > or = 8.5 mmol/l.
Objective:
The purpose of this review and meta-analysis was to evaluate the total surge in the prevalence of GDM when implementing the new IADPSG criteria compared to old GDM crietria and to also rule out any role by the risk factors that could influence the prevalence.
Method:
A review of various cohort and cross-sectional studies was conducted among women with GDM utlizing IADPSG criteria and compared it with the old criteria.
Literature reports from various sources such as PubMed, EMBASE, Cochrane, Open Grey and Grey were included. The relative risk factor was analyzed and subgroup analyses was conducted according to the maternal age, body mass index, study design, screening method etc keeping in view the diagnostic criteria.
Findings:
The prevalence of GDM was found to be greater with an evidence of heterogeneity when the IADPSG criteria was implemented. However, further studies are required to allow an inclination towards homogeneity and review associated benefits, harms and costs of putting IADPSG criteria into practice.
Limitations:
Some limitations that were highlighted in the study included the inability to stratify results according to the minority or geography since there were limited studies focused on that population group.
It can therefore notbe considered conclusive whether there was a profound prevalence of Diabetes mellitus in rural populations and its impact on the prevalence of GDM while implementing the diagnostic criteria.
High statistical heterogeneity was observed and there was no statistically significant publication bias seen in this study.
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