Impact on pregnancy outcomes when changing diagnostic criteria for gestational diabetes in Sweden

Conditions

Gestational diabetes mellitus Pregnancy and Childbirth Gestational diabetes mellitus

Grass S, de Brun M, Magnuson A, Persson M, Wikström AK, Simmons D, Patil S, Sengpiel V, Montgomery S, Berntorp K, Wennerholm UB, Strevens H, Hildén K, Storck-Lindholm E, Backman H, Ahlsson F.

2026-07-29

10.1111/ppe.70180

1039-P: Association of GDM Risk Factors with Glucose at Diagnosis and Treatment in Sweden

HELENA E. FADL, SNEHAL PATIL, ANNA-KARIN WIKSTRÖM, STEFAN P. JANSSON, VERENA SENGPIEL et al. (15 authors)

Diabetes2022-05-31

10.2337/db22-1039-p

Changing diagnostic criteria for gestational diabetes in Sweden - a stepped wedge national cluster randomised controlled trial - the CDC4G study protocol.

Fadl H, Saeedi M, Montgomery S, Magnuson A, Schwarcz E, Berntorp K, Sengpiel V, Storck-Lindholm E, Strevens H, Wikström AK, Brismar-Wendel S, Persson M, Jansson S, Ahlsson F, Ursing C, Ryen L, Petersson K, Wennerholm UB, Hildén K, Simmons D.

2019-11-0127 citations

10.1186/s12884-019-2547-5

Interventions

The intervention is the switch from the pre-existing Swedish diagnostic criteria to the WHO 2013 criteria for GDM to the 3 point OGTT with fasting, 1 hour and/or 2 hour diagnostic thresholds of =5.1,

Eligibility

Sex/Gender

Female

Inclusion criteria

Inclusion criteria: All pregnant women in the participating hospitals and their uptake regions.

Exclusion criteria

Exclusion criteria: Preexisting diabetes mellitus.

Design outcomes

Primary

Measure	Time frame
Large for Gestational Age (LGA) is measured as the weight of the baby will be measured at time of birth.	—

Secondary

Measure	Time frame
Current secondary outcome measures as of 28/02/2019 in accordance with approved ethical protocol from 07/12/2016: 1. Composite of severe adverse outcomes (stillbirth, neonatal death, Erbs palsy, metabolic acidosis defined as pH 12 mmol/l in umbilical artery or pH <7.0 in umbilical artery, Apgar score <4 at 5 minutes, HIE I-III, intracranial haemorrhage, neonatal convulsions, meconium aspiration syndrome, mechanical ventilation) 2. 5-Min Apgar score <7 3. Fractured clavicle 4. Blood glucose in the infants 5. Prematurity <37 weeks 6. NICU admission yes/no 7. NICU days 8. Small for Gestational Age 9. Health economic outcome 10. Incremental Cost Effectiveness Ratio 11. Hypoglycaemia needing IV therapy 12. Phototherapy 13. Blood glucose in the infants Maternal outcomes: 1. Hypertension, Pre-eclampsia-defined is measured using blood pressure and proteinuria at labour and/or discharge 2. Shoulder dystocia is measured using pregnancy quality register (Shoulder dystocia ICD O660) at labour and/or discharge 3. Perineal trauma-3 and 4 degree measured using pregnancy quality register (Perineal trauma ICD O70) at labour and/or discharge 4. Induction of labour is measured using medical records at labour 5. Breastfeeding at hospital discharge 6. Emergency C-section is measured using medical records at labour and/or discharge 7. Elective C-section is measured using medical records at labour and/or discharge 8. Instrumental delivery is recorded using medical records at labour and/or discharge 9. Length of maternal postnatal stay is recorded using medical records at discharge Previous secondary outcome measures: 1. Hypertension, Pre-eclampsia-defined is measured using blood pressure and proteinuria at labour and/or discharge 2. Shoulder dystocia is measured using pregnancy quality register (Shoulder dystocia ICD O660) at labour and/or discharge 3. Perineal trauma-3 and 4 degree measured using pregnancy quality register (Perineal trauma ICD O70) at labour and/or discharge 4. Indu	—

Measure

Time frame

Current secondary outcome measures as of 28/02/2019 in accordance with approved ethical protocol from 07/12/2016: 1. Composite of severe adverse outcomes (stillbirth, neonatal death, Erbs palsy, metabolic acidosis defined as pH 12 mmol/l in umbilical artery or pH <7.0 in umbilical artery, Apgar score <4 at 5 minutes, HIE I-III, intracranial haemorrhage, neonatal convulsions, meconium aspiration syndrome, mechanical ventilation) 2. 5-Min Apgar score <7 3. Fractured clavicle 4. Blood glucose in the infants 5. Prematurity <37 weeks 6. NICU admission yes/no 7. NICU days 8. Small for Gestational Age 9. Health economic outcome 10. Incremental Cost Effectiveness Ratio 11. Hypoglycaemia needing IV therapy 12. Phototherapy 13. Blood glucose in the infants Maternal outcomes: 1. Hypertension, Pre-eclampsia-defined is measured using blood pressure and proteinuria at labour and/or discharge 2. Shoulder dystocia is measured using pregnancy quality register (Shoulder dystocia ICD O660) at labour and/or discharge 3. Perineal trauma-3 and 4 degree measured using pregnancy quality register (Perineal trauma ICD O70) at labour and/or discharge 4. Induction of labour is measured using medical records at labour 5. Breastfeeding at hospital discharge 6. Emergency C-section is measured using medical records at labour and/or discharge 7. Elective C-section is measured using medical records at labour and/or discharge 8. Instrumental delivery is recorded using medical records at labour and/or discharge 9. Length of maternal postnatal stay is recorded using medical records at discharge Previous secondary outcome measures: 1. Hypertension, Pre-eclampsia-defined is measured using blood pressure and proteinuria at labour and/or discharge 2. Shoulder dystocia is measured using pregnancy quality register (Shoulder dystocia ICD O660) at labour and/or discharge 3. Perineal trauma-3 and 4 degree measured using pregnancy quality register (Perineal trauma ICD O70) at labour and/or discharge 4. Indu

—

Countries

Sweden

Outcome results

None listed