The impact of switching to the one-step method for GDM diagnosis on the rates of postpartum screening attendance and glucose disorder in women with prior GDM. The San Carlos Gestational Study

Abstract Aims To compare rates of FPG-HbA1C-based postpartum-glucose disorder (PGD) of women with prior gestational diabetes mellitus (GDM) by Carpenter-Coustan criteria (CCc) versus International Association of Diabetes and Pregnancy Study Groups criteria (IADPSGc). Methods 1620 women with GDM were divided into CCc group (2007-March 2012, n  = 915), and IADPSGc group (April 2012–2013, n  = 705). Pregravid (PG) body weight (BW) and body mass index (BMI) and postdelivery (PD) BW, BMI, waist circumference (WC), HOMA-insulin resistance (HOMA-IR), HbA1c, glucose and lipid profile were analysed. PGD definition: HbA1c ≥ 5.7% and/or FPG ≥ 5.6 mmol/l. Results Postpartum screening attendance rates (PSAr) were similar in both groups, CCc: 791 (86.5%) and IADPSGc: 570 (81%) as in PGD rates (PGDr), CCc: 233 (29.5%) and IADPSGc: 184 (32.3%). Both cohorts had similar PG-BMI, WC and PD-BMI. Both CCc and IADPSGc women had a significantly higher probability of having PGD when PG-BMI ≥ 25 Kg/m 2 (CCc: OR: 1.55; IC 95% 1.06–2.26; p  = 0.016), (IADPSGc: OR: 1.42; IC 95% 1.03–2.38; p  = 0.046) as well as when WC ≥ 89.5 cm, and age ≥ 34 years, and in CCc women when PD-WG > 0 Kg, all adjusted by ethnicity and parity. Conclusions Changing GDM diagnostic methodology did not affect PSAr and PGDr, in spite of screening more women. Thus, using IADPSGc allowed the identification of a larger number of women with PGD.