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ABSTRACT
Gestational diabetes mellitus (GDM) is a serious condition associated to both maternal and offspring complications. Yet, no globally accepted consensus exists on how to test and diagnose GDM. In Greenland, the clinical criteria for testing and diagnosing GDM are adapted from Danish guidelines. The aim of this study was to estimate the prevalence of GDM among Greenlanders using both the current clinical GDM criteria and the recent WHO 2013 criteria and, further, to study the association between GDM, pre-pregnant overweight or obesity and macrosomia. A cross-sectional study of all 450 Greenlandic women who gave birth to a singleton in Nuuk within 1 year was performed. Based on an oral glucose tolerance test measuring capillary whole blood glucose, 119 women were categorised as having clinical GDM, WHO 2013 GDM or not GDM. Macrosomia defined as birth weight above 4,000 g was used as outcome variable. The prevalence of clinical GDM and WHO 2013 GDM was 0.4% (95% CI; 0-1.1) and 6.9% (95% CI; 4.5-9.2). WHO 2013 GDM, fasting blood glucose, pre-pregnant maternal overweight and obesity were associated with macrosomia. WHO 2013 GDM criteria were superior to clinical criteria in predicting macrosomia indicating that it may be time to consider the diagnostic strategy used in Greenland. Pre-pregnant overweight may also need more intensified lifestyle-intervention.
Abbreviations: GDM: Gestational diabetes mellitus; VP: venous plasma; CWB: capillary whole blood; OGTT: oral glucose tolerance test; WHO: World Health Organisation; FIGO: The International Federation of Gynaecology and Obstetrics; BMI: body mass index; GA: gestational age
ARTICLE HISTORY
Received 16 May 2018
Revised 20 August 2018
Accepted 10 September 2018
KEYWORDS
Gestational diabetes; diagnostic; prevalence; macrosomia; overweight; inuit; Greenland
Introduction
Gestational diabetes mellitus (GDM) is defined as hyperglycaemia diagnosed during pregnancy [1]. GDM is associated with maternal and offspring complications like macrosomia, caesarean delivery, preterm birth, intrauterine death, preeclampsia, shoulder dystocia, neonatal hypoglycaemia and hyperbilirubinaemia [2,3]. Women diagnosed with GDM have an increased risk at around 50% of developing diabetes later in life [4,5]. Also, offspring of mothers with GDM have increased risk of obesity and diabetes later in life [6,7]. Globally, the prevalence of GDM has increased within the last 20 years [8,9]. The first study of GDM performed in Greenland reported a very low prevalence of GDM among women...