Table 3.
Associations between glucose measures, diagnosis of gestational diabetes and pregnancy outcomes
| Study | Population | Total, n | OGTT, n | Design | Outcome |
Random plasma glucose 12 weeks |
HbA1c 28 weeks |
FPG 28 weeks |
OGTT time 60 28 weeks |
OGTT time 120 28 weeks |
|---|---|---|---|---|---|---|---|---|---|---|
|
Diagnosis: receiver‐operating characteristic curves |
AUROC (95% CI) |
AUROC (95% CI) |
AUROC (95%CI) |
AUROC (95%CI) |
AUROC (95%CI) |
|||||
|
OPHELIA |
Antenatal population with ≥1 GDM risk factor |
361 | 361 | Prospective | NICE‐GDM | No data | 0.83 (0.75‐‐0.90)*** | 0.75 (0.65‐0.85)*** | no data | 0.93 (0.86‐1.00)*** |
| 361 | 361 | Prospective | IADPSG‐GDM | No data | 0.84 (0.77‐‐0.91)*** | 0.92 (0.85‐0.98)*** | no data | 0.83 (0.75‐0.92)*** | ||
|
Older CUHFT |
Antenatal population with positive glucose challenge test† | 17736 | 3764 | Retrospective | NICE‐GDM | 0.81 (0.79‐‐0.83)*** | No data | 0.69 (0.67‐0.71)*** | 0.83 (0.82‐0.85)*** | 0.99 (0.98‐0.99)*** |
| 17736 | 3764 | Retrospective | IADPSG‐GDM | 0.81 (0.79‐‐0.83)*** | No data | 0.79 (0.77‐0.80)*** | 0.93 (0.92‐0.94)*** | 0.85 (0.84‐0.86)*** | ||
|
Diagnosis: unadjusted logistic regression |
OR (95%CI) |
OR (95%CI) |
OR (95%CI) |
OR (95%CI) |
OR (95%CI) |
|||||
|---|---|---|---|---|---|---|---|---|---|---|
|
Older CUHFT |
Antenatal population with positive glucose challenge at 24 weeks | 17736 | 3764 | Retrospective | NICE‐GDM | 2.35 (2.24‐‐2.46)*** | No data | 4.84 (4.13‐5.67)*** | 2.29 (2.16‐2.44)*** | 348.82 (200.76‐606.07)*** |
| 17736 | 3764 | Retrospective | IADPSG‐GDM | 2.45 (2.34‐‐2.57)*** | No data | 16.00 (12.98‐19.71)*** | 5.76 (5.11‐6.49)*** | 3.66 (3.35‐4.01)*** | ||
|
Recent CUHFT |
Women with ≥1 GDM risk factor according to the IADPSG criteria |
826 | 826 | Prospective | NICE‐GDM | No data | n/a | n/a | no data | n/a |
| 826 | 826 | Prospective | IADPSG‐GDM | No data |
n/a |
n/a |
no data |
n/a |
||
|
Pregnancy outcomes: unadjusted logistic regression |
OR (95% CI) |
OR (95% CI) |
OR (95% CI) |
OR (95% CI) |
OR (95% CI) |
|||||
|---|---|---|---|---|---|---|---|---|---|---|
|
Older CUHFT |
Antenatal population with positive glucose challenge at 24 weeks | 17736 | 3764 | Retrospective | LGA infant | 1.10 (1.06‐‐1.13)*** | No data | 1.87 (1.63‐2.14)*** | 1.11 (1.06‐1.15)*** | 1.04 (0.99‐1.10) |
| 17736 | 3764 | Retrospective | CS | 1.15 (1.21‐1.17)*** | No data | 1.48 (1.32‐1.67)*** | 1.10 (1.06‐1.14)*** | 1.11 (1.06‐1.15)*** | ||
| 17736 | 3764 | Retrospective | NH | No data | No data | No data | No data | No data | ||
| 17736 | 3764 | Retrospective | NICU | 1.06 (1.02‐1.11)** | No data | 1.03 (0.82‐1.28) | 1.02 (0.95‐1.10) | 1.05 (0.97‐‐1.14) | ||
|
Recent CUHFT |
Women with ≥1 GDM risk factor according to the IADPSG criteria |
826 | 826 | Prospective | LGA infant | no data | 1.04 (1.00‐‐1.08)* | 1.28 (1.01‐‐1.62)* | No data | 1.02 (0.92‐‐1.14) |
| 826 | 826 | Prospective | CS | no data | 1.04 (1.01‐‐1.08)** | 1.06 (0.88‐‐1.28) | No data | 1.04 (0.95‐‐1.13) | ||
| 826 | 826 | Prospective | NH | no data | 1.05 (1.02‐‐1.08)** | 0.95 (0.79‐‐1.15) | No data | 1.00 (0.92‐‐1.08) | ||
| 826 | 826 | Prospective | NICU | no data | 1.02 (0.98‐‐1.06) | 1.21 (0.94‐‐1.54) | No data | 0.93 (0.83‐‐1.04) | ||
AUROC, area under the receiver‐operating characteristic curve; CS, Caesarean section; CUHFT, Cambridge University Hospital NHS Foundation Trust; FPG, fasting plasma glucose; GDM, gestational diabetes; IADPSG, International Association of Diabetes and Pregnancy Study Groups; LGA, large‐for‐gestational‐age; NICE, National Institute for Health and Care Excellence; NICU, neonatal intensive care unit; NH, neonatal hypoglycaemia; NICU. neonatal intensive care unit; OR, odds ratio.
NH defined as neonatal glucose <2.6 mmol/l at least 4 h after birth. NICU admission defined as >24 h. OPHELIA included 361 women (8.3% with NICE‐defined GDM) all offered standard clinical management. Older CUHFT data included 4.3% of women (4.5% using current NICE GDM criteria) offered standard clinical management. The recent CUHFT data includes women with IADPSG‐defined GDM, all of whom were offered standard clinical management. ORs were calculated using continuous measures. *P < 0.05; **P<0.01; ***P<0.001. †Glucose >7.8 mmol/l, 1 h after a universal 50‐g glucose challenge at 24 weeks' gestation.