Background:
Gestational diabetes mellitus (GDM) is defined as hyperglycaemia first detected at any time during pregnancy. GDM increases the risk of adverse pregnancy outcomes including preeclampsia, and neonatal complications including hypoglycaemia and respiratory distress. The Australasian Diabetes in Pregnancy Society (ADIPS) has recently introduced a new consensus recommendation for the diagnosis of GDM.
Aim:
To evaluate neonatal and maternal outcomes in women who would and would not have been diagnosed with gestational diabetes mellitus (GDM) under the updated ADIPS recommendations.
Methods:
A retrospective chart review was undertaken using data from the RHW Diabetes in Pregnancy database, and eMaternity between 2022 and 2024 to identify women diagnosed with GDM and treated during their pregnancies. The maternal and neonatal outcomes of these women were compared after dividing them into those who would and would not have been diagnosed according to the new ADIPS criteria.
Results:
Implementation of the new criteria will reduce the number of patients diagnosed with GDM by 40%. Patients who would not have been diagnosed with GDM still required treatment (45%), experienced perineal trauma (29%) and developed hypertensive disorders of pregnancy (3.5%). Adverse neonatal outcomes included increased birth weight, admission to the NICU (17%), neonatal hypoglycaemia (3-8%) and respiratory distress (12%).
Conclusion:
In a retrospective cohort of women treated with GDM, those who would no longer be identified as having GDM have adverse maternal and perinatal outcomes. Following implementation of the new ADIPS guidelines, it is imperative we monitor and review these outcomes to ensure safety.