Five-year follow-up of maternal and child health after gestational diabetes mellitus diagnosed using different glycaemic criteria: The GEMS follow-up study.

AIMS: This study assessed whether diagnosing gestational diabetes (GDM) using lower IADPSG versus higher New Zealand criteria improved maternal and child health five years later.

METHODS

Follow-up of participants from the GEMS trial, allocated to GDM diagnosis using either IADPSG criteria (fasting ≥5.1, 1-hour ≥10.0 and/or 2-hour ≥8.5 mmol/L), or New Zealand criteria (fasting ≥5.5 and/or 2-hour ≥9.0 mmol/L). Primary outcomes were maternal type 2 diabetes/prediabetes and child BMI z-score. Secondary/tertiary outcomes included maternal cardiometabolic risks, child growth and neurodevelopment.

RESULTS

Of 1,206 eligible participants, 869 women (72 %) and 833 children (69 %) were assessed. Maternal diabetes/prediabetes were similar between the IADPSG and New Zealand criteria groups (20.5 % vs 16.5 %, p = 0.10), as were child BMI z-scores (0.36 vs 0.50, p = 0.14). Women in the IADPSG criteria group, compared to those in the New Zealand criteria group, had less hypertension and pharmaceutical use but more GDM in subsequent pregnancies. Their children had lower rates of overweight and neurodevelopmental impairment. Maternal diabetes rates and child BMI z-scores were similar between participants with treated or untreated mild gestational hyperglycaemia.

CONCLUSIONS

GDM diagnosis using the IADPSG criteria did not reduce maternal diabetes or child BMI five-years later, but was associated with other health benefits.