A new study published in the New England Journal of Medicine has shown that 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.

More than 4,061 women at 24 to 32 weeks’ gestation were chosen randomly 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).

Gestational diabetes was diagnosed in 310 of the 2,022 women in the lower-glycaemic-criteria group and in 124 of the 2,039 in the higher-glycaemic-criteria group.

Among the 2,019 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 of the survey also showed that the induction of labour, use of health services, use of pharmacologic agents and neonatal hypoglycaemia were more common in the lower-glycaemic-criteria group than in the higher-glycaemic-criteria group.

To access the full study, click here.