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Background: The adoption of the International Association of Diabetes Study Groups (IADPSG) criteria for gestational diabetes mellitus (GDM) in Australia has been controversial. Obesity in pregnancy is also a growing concern. Aims: To assess the impact of IADPSG criteria on the incidence of GDM and pregnancy outcomes, and to compare this to the effect of obesity, particularly among women who would not have GDM by the Australasian Diabetes in Pregnancy Society 1998 criteria (ADIPS1998). Material and Methods: A retrospective observational cohort study linking results of 75 g glucose tolerance tests with demographic and pregnancy data was conducted. Results: In our cohort of 6175 pregnancies, GDM was present in 926 (15%) women by the ADIPS1998 criteria; it increased to 1098 (17.8%) women by the IADPSG criteria. Among the 5248 pregnancies which did not meet the ADIPS1998 criteria and were not treated for GDM, women with IADPSG GDM had increased risk of gestational hypertension, pre‐eclampsia, induction of labour (IOL), primary caesarean section (PCS) and large for gestational age (LGA) compared to women without GDM (all P < 0.05), whereas obese women had increased risk of gestational hypertension, pre‐eclampsia, IOL, PCS, small for gestational age (SGA) and shoulder dystocia compared to women of normal weight (all P < 0.05). On multivariate analysis, IADPSG GDM was an independent risk factor only for IOL (P = 0.04) and LGA (<0.001). Obesity was an independent risk factor for gestational hypertension, pre‐eclampsia, IOL, PCS, shoulder dystocia and SGA (all P < 0.001). Conclusions: Within our population, of women who are not currently treated for GDM, obesity is associated with greater pregnancy risk than GDM diagnosed by IADPSG criteria. [ABSTRACT FROM AUTHOR]

Diabet. Med. 28, 1074-1077 (2011) Abstract Aims The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) Consensus Panel recommends new criteria for diagnosing gestational diabetes. We evaluated the clinical and metabolic characteristics, and pregnancy outcome, in women previously classifiable as 'normal' according to the 4th International Workshop Conference on gestational diabetes criteria, but reclassified as 'abnormal' according to the new recommendations. Methods Using the new IADPSG criteria, 3953 pregnancies were retrospectively reclassified as 1815 women with normal glucose tolerance and 2138 with gestational diabetes, 112 (2.8%) of whom would have been classified as normal according to the older criteria. Results Of the 2138 women classified as abnormal by the new criteria, the 112 women now reclassified as abnormal were younger and had a lower pre-pregnancy BMI than the 2026 women who had also been classified as abnormal by the previous criteria. The 100-g oral glucose tolerance test showed significantly higher glucose levels in these 112 women than in the 1815 women reclassified as normal ( P < 0.0001). Caesarean section was significantly more frequent ( P < 0.01) and the ponderal index for the newborn significantly higher in these reclassified women than in those classified as normal ( P < 0.0001), and their basal glucose levels correlated significantly with the ponderal index ( P < 0.05). Conclusion The new criteria for diagnosing gestational diabetes identified a group of women previously classifiable as normal according to the 4th International Workshop Conference criteria, but revealing metabolic characteristics and pregnancy outcomes resembling those of women who would have been considered to have gestational diabetes by the previous criteria. [ABSTRACT FROM AUTHOR]