The use of lower glycaemic criteria for the diagnosis of gestational diabetes did not result in a lower risk of a large-for-gestational-age infant than the use of higher glycaemic criteria, a new study published in the New England Journal of Medicine has identified.
A team of scientists randomly assigned more than 4,000 women at 24 to 32 weeks’ gestation in a 1:1 ratio to be evaluated for gestational diabetes with the use of lower or higher glycaemic criteria for diagnosis.
The lower glycaemic criterion was a fasting plasma glucose level of at least 92 mg per deciliter (≥5.1 mmol per liter), a one-hour level of at least 180 mg per deciliter (≥10.0 mmol per liter), or a two-hour level of at least 153 mg per deciliter (≥8.5 mmol per liter). The higher glycaemic criterion was a fasting plasma glucose level of at least 99 mg per deciliter (≥5.5 mmol per liter) or a two-hour level of at least 162 mg per deciliter (≥9.0 mmol per liter).
Among 2019 infants born to women in the lower-glycaemic-criteria group, 178 (8.8%) were large for gestational age, and among 2,031 infants born to women in the higher-glycaemic-criteria group, 181 (8.9%) were large for gestational age (adjusted relative risk, 0.98; 95% confidence interval, 0.80 to 1.19; P=0.82).
The results also show that the induction of labour, use of health services, use of pharmacologic agents, and neonatal hypoglycaemia were more common in the lower-glycemic-criteria group than in the higher-glycemic-criteria group.
To access the full study, click here.