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Risk factors for gestational diabetes mellitus among women screened with the two-step and one-step methods: A
Tai-Ho Hung1, Fu-Ling Chu2, T'sang-T'ang Hsieh3
1Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Objective:
To compare the risk profiles for gestational diabetes mellitus (GDM) using a one-step and two-step screening method and diagnostic criteria.
Materials And Methods:
A retrospective cohort study was conducted among women screened using Carpenter and Coustan's (C&C) criteria (two-step method) and the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria (one-step method). All deliveries after 28 weeks of gestation, except for pregnancies complicated by pre-pregnancy diabetes mellitus, were analyzed. Multiple logistic regression was used to assess the associations between GDM and various potential risk factors.
Results:
Risk factors for C&C-defined GDM were pre-pregnancy body mass index >24.2 kg/m2 (adjusted odds ratio [OR] 2.49, 95% confidence interval [CI] 1.92-3.23), maternal age at delivery >34 years (adjusted OR 2.46, 95% CI 1.96-3.09), history of fetal death (adjusted OR 2.56, 95% CI 1.37-4.78), and chronic hypertension (adjusted OR 3.66, 95% CI 1.50-8.91). In addition to these factors, conception assisted by reproductive technology (adjusted OR 1.64, 95% CI 1.19-2.25) and genetic amniocentesis (adjusted OR 1.19, 95% CI 1.03-1.38) were IADPSG-defined GDM risk factors.
Conclusion:
Risk factors for GDM differ with the diagnostic criteria used. This information is important when changing GDM screening strategies from the two-step approach to the one-step approach.
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