مقايسه استفاده از مقياس كارپينتر كوستان با مقياس گروه ملي داده هاي ديابت در ارزيابي پيامدهاي نامطلوب بارداري

Comparison of Carpenter- Coustan Criteria and National Diabetes Data Group Criteria in Evaluation of Adverse Pregnancy Outcome

BACKGROUND AND OBJECTIVE: Early diagnosis of gestational diabetes is very important and there are different criteria for diagnose of gestational diabetes. The aim of this study was to compare Carpenter- Coustan (C&C) and National Diabetes Data Group (NDDG) criteria in evaluation of adverse pregnancy outcome METHODS: This cohort study was done in prenatal care on 200 pregnant women who had abnormal GCT (Glucose challenge test) and normal GTT (Glucose tolerance test) based on NDDG criteria and 200 pregnant women (control group) who had normal GCT. Patients were compared in three groups included: normal GCT, normal GTT on both criteria and a group with normal GTT in NDDG criteria and abnormal GTT in C&C criteria for pregnancy outcome such as macrosomia, premature rupture membrane (PROM) need to cesarean section (C/S). FINDINGS; According to C&C criteria 24 (6%) patients had abnormal test but these patients was normal according NDDG criteria. PROM (OR=2.23, CI95%: 1.14-4.35), macrosomia (OR=3.73, CI95%: 1.54-9.01) and cesarean section (OR=1.73, CI95%: 1.05-2.84) in patients with abnormal test result according to both criteria was significantly higher than patients with normal GCT (control), but the risk of preeclampsia (OR=2.64, CI95%: 0.79- 8.73) was not significantly different between the two groups. Risk of preeclampsia (OR=2.23, CI95%: 0.77-25.7) and cesarean section (OR=4.06, CI95%:0.92-17.8) in the group with only abnormal GTT by C&C criteria had higher than people who were normal by both criteria. Presence of at least one outcome (OR=7.6, CI95%: 1.01-12.8) in the group with only abnormal GTT by C&C criteria had significantly higher than people who were normal by both criteria. CONCLUSION: The results of this study showed that the risk of adverse pregnancy outcome in patients with normal GTT according to NDDG criteria but gestational diabetes by C&C was higher than women with normal GCT