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KMID : 0876319990010020127
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Cachon Medical Journal
1999 Volume.1 No. 2 p.127 ~ p.134
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Comparison of Cirteria from World Health Organization (WHO) and National Diabetes Data Group (NDDG) to Detect Gestational Diabetes and its Related Abnormalitis
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Park Hye-Young
Jung Yon-Sil
Lee Sung-Kwang
Kim Hong-Kyu
Kang Moon-Ho
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Abstract
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Purpose: Gestational diabetes mellitus, defined as diabetes with onset or detection during pregnancy, is associated with complications both of the mother and the infant in the perinatal period. Currently, two sets of criteria are recommended for the diagnosis of gestational diabetes. One is the one-step WHO criteria which defines both diabetes and impaired glucose tolerance. The other is the two-step procedure proposed by NDDG. This study is to compare the WHO and NDDG criteria in the effectiveness of detecting abnormal glucose tolerance and its related complications during pregnancy.
Materials and Methods: Pregnant women in the latter half of the gestational period have both a 1-h and a 2-h glucose concentration measurements after an oral 75g glucose load. Those who have a 1-h glucose concentration ≥7.8mmol/L undergo a 100g 3-h glucose tolerance test. Data analysis was done on the 78 women who screened positive and completed delivery. To determine the effectiveness of the two tests, we compared the frequency of abnormal pregnancy outcomes such as macrosomia, cesarian section, neonatal hypoglycemia and premature labor.
Results: Of 78 women who had 1-h plasma glucose ≥7.8mmol/L after 75-g load and also had the 100-g test, 10 had diabetes mellitus (DM) and 43 had impaired glucose tolerance (IGT) according to the WHO criteria, and 19 had gestational diabetes mellitus according to the NDDG criteria. Thirty-eight women with a normal test by NDDG criteria had an abnormal glucose tolerance according to WHO criteria mostly IGT (36), and 4 with a normal test by WHO criteria had an abnormal glucose tolerance according to NDDG criteria. Of 15 women delivering macrosomic infants, 13(87%) was abnormal with the WHO criteria, and 9(60%) was abnormal with the NDDG criteria. Of 28 women delivering by cesarean section, 18(64%) was abnormal with the WHO criteria, and 9 (32%) was abnormal with the NDDG criteria. Of 6 cases of neonatal hypoglycemia, 5 were associated with abnormal WHO criteria, and all 6 were associated with abnormal NDDG criteria. Of 5 women with polyhydroamniosis, all had abnormal WHO criteria and 4 had abnormal NDDG criteria.
Conslusion: The simpler one-step WHO criteria is at least as good the NDDG criteria in predicting adverse outcomes related to abnormal glucose tolerance during pregnancy.
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KEYWORD
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Gestational diabetes mellitus, Impaired Glucose Tolearance, Macrosomia, National Diabetes Data Group criteria, World Health Organization criteria
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