Lower Glycemic Criteria for GDM Does Not Cut Risk for LGA Infants

FRIDAY, Aug. 19, 2022 (HealthDay News) -- Use of lower glycemic criteria for the diagnosis of gestational diabetes does not alter the risk for large-for-gestational-age infants, according to a study published in the Aug. 18 issue of the New England Journal of Medicine.

Caroline A. Crowther, M.D., from the University of Auckland in New Zealand, and colleagues randomly assigned 4,061 women at 24 to 32 weeks of gestation to be evaluated for gestational diabetes with the use of lower or higher glycemic criteria for diagnosis. The lower glycemic criterion was a fasting plasma glucose level of ≥92 mg/dL, a one-hour level of ≥180 mg/dL, or a two-hour level of ≥153 mg/dL, while a fasting plasma glucose level of ≥99 mg/dL or a two-hour level of ≥162 mg/dL was the higher glycemic criterion.

The researchers found that gestational diabetes was diagnosed in 15.3 percent of 2,022 women in the lower-glycemic-criteria group and in 6.1 percent of 2,039 women in the higher-glycemic-criteria group. Among 2,019 and 2,031 infants born to women in the lower- and higher-glycemic-criteria groups, 8.8 and 8.9 percent, respectively, were large for gestational age. Compared with the higher-glycemic-criteria group, in the lower-glycemic-criteria group, induction of labor, use of health services, use of pharmacologic agents, and neonatal hypoglycemia were more common. For the other secondary outcomes, the results were similar between the two trial groups. In addition, adverse events did not differ substantially between the groups.

"The risks of giving birth to a large-for-gestational-age infant and of other infant or maternal complications were not lower with the lower glycemic criteria than with the higher glycemic criteria," the authors write.

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