Changes to Gestational Diabetes Mellitus (GDM) Testing and Associations with the GDM Prevalence and Large- and Small-for-Gestational-Age Infants—An Observational Study in an Australian Jurisdiction, 2012–2019
<b>Background:</b> Two changes to gestational diabetes mellitus (GDM) testing were implemented in the Australian Capital Territory in 2015 and 2017. <b>Aims:</b> We aimed to determine the associations between testing regimes and the prevalence of GDM and large-for-gestational...
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2025-06-01
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| author | Jennifer Hutchinson Catherine R. Knight-Agarwal Christopher J. Nolan Deborah Davis |
| author_facet | Jennifer Hutchinson Catherine R. Knight-Agarwal Christopher J. Nolan Deborah Davis |
| author_sort | Jennifer Hutchinson |
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| description | <b>Background:</b> Two changes to gestational diabetes mellitus (GDM) testing were implemented in the Australian Capital Territory in 2015 and 2017. <b>Aims:</b> We aimed to determine the associations between testing regimes and the prevalence of GDM and large-for-gestational-age (LGA) and small-for-gestational-age (SGA) infants and to compare the prevalence of LGA and SGA infants between women with and without GDM in each testing period. <b>Methods:</b> A total of 23,790 singleton live births with estimated GDM testing and birth dates between June 2012 and December 2019 were stratified into groups: pre-testing changes (June 2012–December 2014, group 1, <i>n</i> = 8069), revised diagnostic criteria (January 2015–May 2017, group 2, <i>n</i> = 8035) and changed pathology centrifugation protocol (June 2017-December 2019, group 3, <i>n</i> = 7686). Women were allocated to groups based on their estimated GDM testing date and stratified by their GDM status. A chi-square test, pairwise z-tests and logistic regression tested the associations. <b>Results:</b> The GDM prevalence significantly increased from 9.5% (group 1) to 19.4% (group 2) to 26.3% (group 3) (all: <i>p</i> < 0.001). The LGA infant prevalence significantly decreased in non-GDM women following revised diagnostic criteria implementation (11.6% vs. 9.7%, <i>p</i> = 0.001). Compared to group 1, women with GDM in groups 2 and 3 had significantly reduced odds of having LGA infants (aOR = 0.73, 95% CI of 0.56–0.95 and <i>p</i> = 0.021 and aOR = 0.75, 95% CI of 0.59–0.97 and <i>p</i> = 0.029, respectively). Compared to group 1, non-GDM women in groups 2 and 3 had significantly reduced odds of having LGA infants (aOR = 0.83, 95% CI of 0.74–0.92 and <i>p</i> < 0.001 and aOR = 0.88, 95% CI of 0.79–0.99 and <i>p</i> = 0.026, respectively). There were no significant associations for group 3 compared to group 2 nor for SGA infants. <b>Conclusions:</b> While significantly increasing the GDM prevalence, implementing the testing changes was associated with a reduced whole-population LGA infant prevalence without a change in the SGA infant prevalence. |
| format | Article |
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| spelling | doaj-art-02da010c25264fd28aa6cd77aa6fa5da2025-08-20T03:26:52ZengMDPI AGDiabetology2673-45402025-06-01665410.3390/diabetology6060054Changes to Gestational Diabetes Mellitus (GDM) Testing and Associations with the GDM Prevalence and Large- and Small-for-Gestational-Age Infants—An Observational Study in an Australian Jurisdiction, 2012–2019Jennifer Hutchinson0Catherine R. Knight-Agarwal1Christopher J. Nolan2Deborah Davis3Faculty of Health, University of Canberra, Canberra 2617, AustraliaFaculty of Health, University of Canberra, Canberra 2617, AustraliaSchool of Medicine and Psychology, College of Science and Medicine, Australian National University, Canberra 2601, AustraliaFaculty of Health, University of Canberra, Canberra 2617, Australia<b>Background:</b> Two changes to gestational diabetes mellitus (GDM) testing were implemented in the Australian Capital Territory in 2015 and 2017. <b>Aims:</b> We aimed to determine the associations between testing regimes and the prevalence of GDM and large-for-gestational-age (LGA) and small-for-gestational-age (SGA) infants and to compare the prevalence of LGA and SGA infants between women with and without GDM in each testing period. <b>Methods:</b> A total of 23,790 singleton live births with estimated GDM testing and birth dates between June 2012 and December 2019 were stratified into groups: pre-testing changes (June 2012–December 2014, group 1, <i>n</i> = 8069), revised diagnostic criteria (January 2015–May 2017, group 2, <i>n</i> = 8035) and changed pathology centrifugation protocol (June 2017-December 2019, group 3, <i>n</i> = 7686). Women were allocated to groups based on their estimated GDM testing date and stratified by their GDM status. A chi-square test, pairwise z-tests and logistic regression tested the associations. <b>Results:</b> The GDM prevalence significantly increased from 9.5% (group 1) to 19.4% (group 2) to 26.3% (group 3) (all: <i>p</i> < 0.001). The LGA infant prevalence significantly decreased in non-GDM women following revised diagnostic criteria implementation (11.6% vs. 9.7%, <i>p</i> = 0.001). Compared to group 1, women with GDM in groups 2 and 3 had significantly reduced odds of having LGA infants (aOR = 0.73, 95% CI of 0.56–0.95 and <i>p</i> = 0.021 and aOR = 0.75, 95% CI of 0.59–0.97 and <i>p</i> = 0.029, respectively). Compared to group 1, non-GDM women in groups 2 and 3 had significantly reduced odds of having LGA infants (aOR = 0.83, 95% CI of 0.74–0.92 and <i>p</i> < 0.001 and aOR = 0.88, 95% CI of 0.79–0.99 and <i>p</i> = 0.026, respectively). There were no significant associations for group 3 compared to group 2 nor for SGA infants. <b>Conclusions:</b> While significantly increasing the GDM prevalence, implementing the testing changes was associated with a reduced whole-population LGA infant prevalence without a change in the SGA infant prevalence.https://www.mdpi.com/2673-4540/6/6/54gestational diabetes mellitusdiagnostic criteriaglycolysisOGTTglucosepregnancy |
| spellingShingle | Jennifer Hutchinson Catherine R. Knight-Agarwal Christopher J. Nolan Deborah Davis Changes to Gestational Diabetes Mellitus (GDM) Testing and Associations with the GDM Prevalence and Large- and Small-for-Gestational-Age Infants—An Observational Study in an Australian Jurisdiction, 2012–2019 Diabetology gestational diabetes mellitus diagnostic criteria glycolysis OGTT glucose pregnancy |
| title | Changes to Gestational Diabetes Mellitus (GDM) Testing and Associations with the GDM Prevalence and Large- and Small-for-Gestational-Age Infants—An Observational Study in an Australian Jurisdiction, 2012–2019 |
| title_full | Changes to Gestational Diabetes Mellitus (GDM) Testing and Associations with the GDM Prevalence and Large- and Small-for-Gestational-Age Infants—An Observational Study in an Australian Jurisdiction, 2012–2019 |
| title_fullStr | Changes to Gestational Diabetes Mellitus (GDM) Testing and Associations with the GDM Prevalence and Large- and Small-for-Gestational-Age Infants—An Observational Study in an Australian Jurisdiction, 2012–2019 |
| title_full_unstemmed | Changes to Gestational Diabetes Mellitus (GDM) Testing and Associations with the GDM Prevalence and Large- and Small-for-Gestational-Age Infants—An Observational Study in an Australian Jurisdiction, 2012–2019 |
| title_short | Changes to Gestational Diabetes Mellitus (GDM) Testing and Associations with the GDM Prevalence and Large- and Small-for-Gestational-Age Infants—An Observational Study in an Australian Jurisdiction, 2012–2019 |
| title_sort | changes to gestational diabetes mellitus gdm testing and associations with the gdm prevalence and large and small for gestational age infants an observational study in an australian jurisdiction 2012 2019 |
| topic | gestational diabetes mellitus diagnostic criteria glycolysis OGTT glucose pregnancy |
| url | https://www.mdpi.com/2673-4540/6/6/54 |
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