The HAPO study established which correlation that changed gestational diabetes diagnostic thresholds worldwide?
- A Continuous, graded relationship between maternal glycaemia and adverse perinatal outcomes without a clear threshold ✓
- B A threshold effect at fasting plasma glucose > 7 mmol/L below which no adverse outcomes occur
- C Equivalence of 50 g GCT and 75 g OGTT for GDM diagnosis
- D Superiority of insulin over metformin in reducing macrosomia
Correct answer: A. Continuous, graded relationship between maternal glycaemia and adverse perinatal outcomes without a clear threshold
Explanation
The HAPO (Hyperglycemia and Adverse Pregnancy Outcomes) study, published in NEJM 2008, demonstrated a continuous, graded association between maternal glucose levels (even below diabetic thresholds) and adverse outcomes including birth weight > 90th percentile, primary cesarean delivery, neonatal hypoglycaemia, and cord C-peptide > 90th percentile. This linear relationship (no evident threshold) formed the scientific basis for the IADPSG diagnostic criteria for GDM adopted globally.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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