Table of Contents
ISRN Endocrinology
Volume 2013, Article ID 387495, 8 pages
http://dx.doi.org/10.1155/2013/387495
Clinical Study

Gestational Diabetes Mellitus: Screening and Outcomes in Southern Italian Pregnant Women

1Complex Operative Structure Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
2Department of Health Sciences, University “Magna Græcia” of Catanzaro, Viale Europa (Località Germaneto), 88100 Catanzaro, Italy

Received 8 July 2013; Accepted 4 August 2013

Academic Editors: J. Pachucki, H. Tamemoto, and K. Zajickova

Copyright © 2013 Carmelo Capula et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Recent Italian guidelines exclude women <35 years old, without risk factors for gestational diabetes mellitus (GDM), from screening for GDM. To determine the effectiveness of these measures with respect to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria, we evaluated 2,448 pregnant women retrospectively enrolled in Calabria, southern Italy. GDM was diagnosed following the IADPSG 2010 criteria. Among 538 women <35 years old, without risk factors, who would have not been tested according to the Italian guidelines, we diagnosed GDM in 171 (31.8%) pregnants (7.0% of total pregnants). Diagnosis was made at baseline (55.6%), 1 hour (39.8%), or 2 hours (4.7%) during OGTT. Despite of appropriate treatment, GDM represented a risk factor for cesarean section, polyhydramnios, increased birth weight, admission to neonatal intensive care units, and large for gestational age. These outcomes were similar to those observed in GDM women at high risk for GDM. In conclusion, Italian recommendations failed to identify 7.0% of women with GDM, when compared to IADPSG criteria. The risk for adverse hyperglycaemic-related outcomes is similar in low-risk and high-risk pregnants with GDM. To limit costs of GDM screening, our data suggest to restrict OGTT to two steps (baseline and 1 hour).