In the HAPO (Hyperglycaemia and Adverse Pregnancy Outcomes) study, which fasting plasma glucose threshold at the OGTT was associated with a 1.75-fold increase in adverse pregnancy outcomes, forming the basis of IADPSG criteria for GDM diagnosis?

• A 100 mg/dL (5.6 mmol/L)
• B 110 mg/dL (6.1 mmol/L)
• C 126 mg/dL (7.0 mmol/L)
• D 92 mg/dL (5.1 mmol/L) ✓

Explanation

The HAPO study demonstrated a continuous, graded relationship between maternal glucose levels and adverse outcomes (caesarean section, macrosomia, cord C-peptide, neonatal hypoglycaemia). The IADPSG (International Association of Diabetes and Pregnancy Study Groups) used the HAPO data to define GDM diagnostic thresholds: fasting glucose ≥92 mg/dL (5.1 mmol/L), 1-hour ≥180 mg/dL (10.0 mmol/L), and 2-hour ≥153 mg/dL (8.5 mmol/L) — any one value met on a 75g OGTT diagnoses GDM. These thresholds correspond to the odds ratios for adverse outcomes seen in HAPO.

Reference: Williams Obstetrics, 26th ed.

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