The HAPO (Hyperglycemia and Adverse Pregnancy Outcomes) Study established new diagnostic thresholds for gestational diabetes. Based on HAPO, the IADPSG (2010) criterion for GDM diagnosis at the 75 g OGTT is fasting glucose ≥92 mg/dL, 1-hour ≥180 mg/dL, or 2-hour ≥153 mg/dL. This is based on finding that adverse pregnancy outcomes increased significantly above which odds ratio threshold?

• A 1.50-fold increased odds of primary outcomes
• B 2.0-fold increased odds of primary outcomes
• C 2.5-fold increased odds of primary outcomes
• D 1.75-fold increased odds of primary outcomes ✓

Explanation

The HAPO study (2008) examined the continuous relationship between maternal hyperglycemia and adverse outcomes (LGA, cesarean delivery, neonatal hypoglycemia, cord C-peptide). The IADPSG used the glucose levels at which the odds of adverse outcomes reached 1.75 times baseline as the diagnostic threshold for GDM. This 1.75-fold odds cutpoint generated the now widely-used one-step 75 g OGTT criteria (fasting ≥92, 1-h ≥180, 2-h ≥153 mg/dL).

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.