Screening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes

Abstract There are currently several diagnostic criteria for gestational diabetes (GDM). Both the WHO -2013 and NICE diagnose GDM based on a single step 75 g OGT; however; each uses different glucose thresholds. Previous studies have shown that the prevalence of GDM using the NICE criteria (GDM-N) i...

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Autores principales:	Mohammed Bashir, Ibrahim Ibrahim, Fatin Eltaher, Stephen Beer, Khaled Baagar, Mahmoud Aboulfotouh, Justin C. Konje, Abdul-Badi Abou-Samra
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7cc4b234a67a4684bcd7cff05d297d3c
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spelling	oai:doaj.org-article:7cc4b234a67a4684bcd7cff05d297d3c2021-12-02T13:19:20ZScreening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes10.1038/s41598-021-84918-y2045-2322https://doaj.org/article/7cc4b234a67a4684bcd7cff05d297d3c2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84918-yhttps://doaj.org/toc/2045-2322Abstract There are currently several diagnostic criteria for gestational diabetes (GDM). Both the WHO -2013 and NICE diagnose GDM based on a single step 75 g OGT; however; each uses different glucose thresholds. Previous studies have shown that the prevalence of GDM using the NICE criteria (GDM-N) is lower than that using the WHO-2013 criteria (GDM-W). Qatar has national diabetes in pregnancy program in which all pregnant women undergo OGTT screening using the WHO-2013 criteria. This study aims to define the prevalence of GDM using both criteria in a high-risk population. This retrospective study included 2000 women who underwent a 75 g (OGTT) between Jan 2016 and Apr 2016 and excluded patients with known pre-conception diabetes, multiple pregnancy, and those who did not complete the OGTT. We then classified the women into GDM-W positive, GDM-N positive but GDM-W negative, and normal glucose tolerance (NGT) population. A total of 1481 women (74%) had NGT using the NICE or the WHO-2013 criteria. The number of patients who met both criteria was 279 subjects (14%) with a good agreement (Kappa coefficient 0.67, p < 0.001). The NICE and the WHO-2013 criteria were discordant in 240 subjects (12% of the cohort); 6.7% met the WHO -2013 criteria only and only 5.3% met the NICE criteria. The frequency of pre-eclampsia, pre-term delivery, Caesarean-section, LGA and neonatal ICU admissions were significantly increased in the GDM-W group. However, the GDM-N positive but GDM-W negative had no increased risk of maternal or fetal complications apart from pregnancy-induced hypertension. The WHO-2013 and the NICE criteria classified a similar proportion of pregnant women, 21.5% and 20.1%, respectively, as having GDM; however, they were concordant in only 14% of the cases. Women who are GDM-N positive but GDM-W negative are not at increased risk of maternal and fetal pregnancy complications, except for pregnancy-induced hypertension. As the NICE criteria are more specific to the UK population, we would recommend the use of the WHO-2013 criteria to diagnose GDM in the MENA region and possibly other regions that do not have the same set-up as the UK.Mohammed BashirIbrahim IbrahimFatin EltaherStephen BeerKhaled BaagarMahmoud AboulfotouhJustin C. KonjeAbdul-Badi Abou-SamraNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mohammed Bashir Ibrahim Ibrahim Fatin Eltaher Stephen Beer Khaled Baagar Mahmoud Aboulfotouh Justin C. Konje Abdul-Badi Abou-Samra Screening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes
description	Abstract There are currently several diagnostic criteria for gestational diabetes (GDM). Both the WHO -2013 and NICE diagnose GDM based on a single step 75 g OGT; however; each uses different glucose thresholds. Previous studies have shown that the prevalence of GDM using the NICE criteria (GDM-N) is lower than that using the WHO-2013 criteria (GDM-W). Qatar has national diabetes in pregnancy program in which all pregnant women undergo OGTT screening using the WHO-2013 criteria. This study aims to define the prevalence of GDM using both criteria in a high-risk population. This retrospective study included 2000 women who underwent a 75 g (OGTT) between Jan 2016 and Apr 2016 and excluded patients with known pre-conception diabetes, multiple pregnancy, and those who did not complete the OGTT. We then classified the women into GDM-W positive, GDM-N positive but GDM-W negative, and normal glucose tolerance (NGT) population. A total of 1481 women (74%) had NGT using the NICE or the WHO-2013 criteria. The number of patients who met both criteria was 279 subjects (14%) with a good agreement (Kappa coefficient 0.67, p < 0.001). The NICE and the WHO-2013 criteria were discordant in 240 subjects (12% of the cohort); 6.7% met the WHO -2013 criteria only and only 5.3% met the NICE criteria. The frequency of pre-eclampsia, pre-term delivery, Caesarean-section, LGA and neonatal ICU admissions were significantly increased in the GDM-W group. However, the GDM-N positive but GDM-W negative had no increased risk of maternal or fetal complications apart from pregnancy-induced hypertension. The WHO-2013 and the NICE criteria classified a similar proportion of pregnant women, 21.5% and 20.1%, respectively, as having GDM; however, they were concordant in only 14% of the cases. Women who are GDM-N positive but GDM-W negative are not at increased risk of maternal and fetal pregnancy complications, except for pregnancy-induced hypertension. As the NICE criteria are more specific to the UK population, we would recommend the use of the WHO-2013 criteria to diagnose GDM in the MENA region and possibly other regions that do not have the same set-up as the UK.
format	article
author	Mohammed Bashir Ibrahim Ibrahim Fatin Eltaher Stephen Beer Khaled Baagar Mahmoud Aboulfotouh Justin C. Konje Abdul-Badi Abou-Samra
author_facet	Mohammed Bashir Ibrahim Ibrahim Fatin Eltaher Stephen Beer Khaled Baagar Mahmoud Aboulfotouh Justin C. Konje Abdul-Badi Abou-Samra
author_sort	Mohammed Bashir
title	Screening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes
title_short	Screening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes
title_full	Screening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes
title_fullStr	Screening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes
title_full_unstemmed	Screening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes
title_sort	screening pregnant women in a high-risk population with who-2013 or nice diagnostic criteria does not affect the prevalence of gestational diabetes
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/7cc4b234a67a4684bcd7cff05d297d3c
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Screening pregnant women in a high-risk population with WHO-2013 or NICE diagnostic criteria does not affect the prevalence of gestational diabetes

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