Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Feb 9;10(4):666.
doi: 10.3390/jcm10040666.

The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

Fahimeh Ramezani Tehrani  1 , Marzieh Saei Ghare Naz  1 , Razieh Bidhendi Yarandi  1 , Samira Behboudi-Gandevani  2
Affiliations
Review

The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

Fahimeh Ramezani Tehrani et al. J Clin Med. .

Abstract

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

Keywords: adverse maternal outcomes; diagnostic criteria; gestational diabetes; meta-analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of literature search.
Figure 2
Figure 2
Meta-analysis forest plot of odds ratio (OR) OR for primary cesarean in women with and without Gestational Diabetes Mellitus (GDM) based on different diagnostic criteria.
Figure 3
Figure 3
Meta-analysis forest plot of OR for the induction of labor among women with and without GDM based on different diagnostic criteria.
Figure 4
Figure 4
Meta-analysis forest plot of OR for maternal hemorrhage among women with and without GDM based on different diagnostic criteria.
Figure 5
Figure 5
Meta-analysis forest plot of OR for pregnancy-related hypertension among women with and without GDM based on different diagnostic criteria.
Figure 6
Figure 6
Meta-analysis forest plot of the mean difference of gestational weight gain among women with and without GDM based on different diagnostic criteria.
Figure 7
Figure 7
Bubble plot of the meta-regression relationships adverse outcomes and GDM classification.
See this image and copyright information in PMC

References

    1. American Diabetes Association Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020. Diabetes Care. 2020;43:S14–S31. doi: 10.2337/dc20-S002. - DOI - PubMed
    1. Behboudi-Gandevani S., Amiri M., Yarandi R.B., Tehrani F.R. The impact of diagnostic criteria for gestational diabetes on its prevalence: A systematic review and meta-analysis. Diabetol. Metab. Syndr. 2019;11:1–18. doi: 10.1186/s13098-019-0406-1. - DOI - PMC - PubMed
    1. Gabbay-Benziv R., Doyle L.E., Blitzer M., Baschat A.A. First trimester prediction of maternal glycemic status. J. Périnat. Med. 2015;43:283–289. doi: 10.1515/jpm-2014-0149. - DOI - PubMed
    1. Giannakou K., Evangelou E., Yiallouros P., Christophi C.A., Middleton N., Papatheodorou E., Papatheodorou S.I. Risk factors for gestational diabetes: An umbrella review of meta-analyses of observational studies. PLoS ONE. 2019;14:e0215372. doi: 10.1371/journal.pone.0215372. - DOI - PMC - PubMed
    1. Plows J.F., Stanley J.L., Baker P., Reynolds C.M., Vickers M.H. The Pathophysiology of Gestational Diabetes Mellitus. Int. J. Mol. Sci. 2018;19:3342. doi: 10.3390/ijms19113342. - DOI - PMC - PubMed

LinkOut - more resources