The HAPO (Hyperglycemia and Adverse Pregnancy Outcomes) Study established the relationship between maternal glucose levels and adverse outcomes. Based on HAPO data, the IADPSG 2010 criteria for GDM diagnosis on a 75g OGTT are thresholds exceeding which values associated with an odds ratio of 1.75 for adverse outcomes?

• A Fasting ≥5.1 mmol/L; 1-hour ≥10.0 mmol/L; 2-hour ≥8.5 mmol/L ✓
• B Fasting ≥5.6 mmol/L; 1-hour ≥10.3 mmol/L; 2-hour ≥8.9 mmol/L
• C Fasting ≥6.1 mmol/L; 2-hour ≥7.8 mmol/L (two-step Carpenter-Coustan)
• D Fasting ≥5.3 mmol/L; 1-hour ≥10.6 mmol/L; 2-hour ≥9.0 mmol/L

Explanation

The IADPSG (International Association of Diabetes and Pregnancy Study Groups) 2010 criteria derived GDM thresholds from the HAPO study by identifying glucose values associated with an odds ratio of 1.75 for composite adverse outcomes (birthweight >90th centile, cord blood C-peptide >90th centile, body fat ≥90th centile): fasting plasma glucose ≥5.1 mmol/L (92 mg/dL), 1-hour ≥10.0 mmol/L (180 mg/dL), or 2-hour ≥8.5 mmol/L (153 mg/dL). Only one value needs to be met. These are now WHO 2013 criteria as well. The Carpenter-Coustan criteria (option C) are the older two-step criteria used in North America.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.