Maternal and neonatal outcomes among Chinese women meeting NICE but not IADPSG criteria for gestational diabetes mellitus: A retrospective cohort study

In China, gestational diabetes mellitus (GDM) is typically diagnosed using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. This study retrospectively analyzed 19152 pregnant women who underwent an oral glucose tolerance test between 2015 and 2021, comparing the IADPSG and the National Institute for Health and Care Excellence (NICE) criteria. GDM prevalence was 20.39% (IADPSG) and 23.67% (NICE, P < 0.01), with a moderate diagnostic agreement (κ = 0.59; P < 0.01). Compared with women having normal glucose tolerance (NGT group), women diagnosed with GDM by either the IADPSG (GDM-I) or NICE (GDM-N) criteria had significantly higher risks of adverse outcomes (including gestational hypertension, preeclampsia, preterm delivery, macrosomia, low birth weight, and neonatal jaundice). However, those diagnosed by NICE but not by IADPSG (GDM-NI) showed no significant increase in adverse maternal or neonatal outcomes except for neonatal jaundice. Furthermore, the GDM-NI group had significantly lower rates of several adverse outcomes compared with the GDM-I group. These findings suggest that, under current clinical management where women diagnosed by IADPSG received treatment while those diagnosed only by NICE did not, the IADPSG criteria classified fewer women as having GDM but identified a group with a higher observed risk of several adverse pregnancy outcomes than did the NICE criteria.