ORIGINAL PAPER Early gestational diabetes mellitus (GDM) is associated with worse pregnancy outcomes compared with GDM diagnosed at 24–28 weeks gestation despite early treatment M. Mustafa 1,2 , D. Bogdanet 1,2 , A. Khattak 1 , L.A. Carmody 1 , B. Kirwan 1 , G. Gaffney 2,3 , P.M. O’Shea 2,4 and F. Dunne 1,2 From the 1 Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Newcastle Rd, Galway, H91 YR71, Ireland, 2 Department of Endocrine, College of Medicine, National University Ireland, University Road, Galway, H91 TK33, Ireland, 3 Department of Obstetrics and Gynecology, Galway University Hospital, Saolta University Health Care Group (SHCG), Newcastle Rd, Galway, H91 YR71, Ireland and 4 Department of Clinical Biochemistry, Galway University Hospital, Newcastle Rd, Galway, H91 YR71, Ireland Address correspondence to Dr M. Mustafa, College of Medicine, Nursing and Health Sciences National University Ireland, Galway, Ireland. email: Dr.mohamadjaffer@yahoo.com; Mohamad.Mustafa@hse.ie Summary Background: Gestational diabetes mellitus (GDM) is associatedþ with adverse pregnancy outcomes compared with women with normal glucose tolerance in pregnancy. The WHO recommends screening at 24–28 weeks gestation for GDM. Women who are diagnosed before 24–28 weeks gestation have a longer intervention period which may impact positively on preg- nancy outcomes. Aim: This study aimed to examine pregnancy outcomes of women with GDM diagnosed <24 weeks gestation compared with those diagnosed at 24–28 weeks in a large Irish cohort. Methods: A retrospective cohort study of 1471 pregnancies in women with GDM diagnosed using IADPSG criteria between September 2012 and April 2016 was conducted. At GDM diagnosis, women were classified as early GDM <24 weeks or stand- ard GDM 24–28 weeks gestation. Results: Women with early GDM had a significantly greater risk of pregnancy-induced hypertension (12.4% vs. 5.3%; P < 0.05), post-partum haemorrhage (8.7% vs. 2.4%; P < 0.05) and post-partum glucose abnormalities (32% vs. 15.6%; P < 0.05). Their offspring had a greater risk of pre-maturity (10.9% vs. 6.6%; P < 0.05), stillbirth (1.4% vs. 0.5%; P < 0.05), large for gesta- tional age (19.1% vs. 13.4% P < 0.05) and need neonatal intensive care (30.7% vs. 22.1%; P < 0.05) compared with offspring of women with standard GDM. Rates of C-section and pre-maturity were still higher in the early GDM group when the two groups where compared based on their post-natal OGTT. Received: 15 January 2020; Revised (in revised form): 3 April 2020 V C The Author(s) 2020. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com 17 QJM: An International Journal of Medicine, 2021, 17–24 doi: 10.1093/qjmed/hcaa167 Advance Access Publication Date: 15 May 2020 Original paper Downloaded from https://academic.oup.com/qjmed/article/114/1/17/5837684 by guest on 04 April 2023