Mei-Chun LU, Song-Shan HUANG, Yuan-Horng YAN, Panchalli WANG, Yueh-Han HSU, Wei CHEN Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan Abstract Introduction The influence of different diagnostic thresholds for gestational diabetes mellitus (GDM) on pregnancy outcomes is not fully understood. Degrees of glucose intolerance according to the Carpenter-Coustan (CC) criteria were less severe than the National Diabetes Data Group (NDDG) criteria for GDM. Recent studies have shown inconsistent results for the risk of adverse pregnancy outcomes between the NDDG and CC criteria. Purpose and Methods The objective was to investigate whether pregnant women who met only the CC criteria but not the NDDG criteria had increased risks of adverse pregnancy outcomes compared to the negative screening group. Patients were classified as follows: (1) negative screening group (2) false-positive screening group, (3) CC-only-GDM (not NDDG) group, and (4) NDDG-GDM group,. Multiple mixed effects logistic regression analysis was used to examine the relationships between the groups and pregnancy outcomes. Results There were 9,002 (78.4%), 1,776 (15.5%), 251 (2.2%), and 457 (4.0%) study pregnancies in the 4 groups. Compared with the negative screening group, the maternal outcomes were not different within groups except for gestational hypertension/preeclampsia. For neonatal outcomes, the CC-only-GDM group had significantly greater risks of macrosomia, low birth weight, and admission to a neonatal intensive care unit [adjusted odds ratio (95% confidence interval): 2.73 ( ), 1.64 ( ), and 1.61 ( ), respectively].Conclusions Our findings showed that the women who met only the CC criteria and those who met NDDG criteria had significant increased risks of adverse neonatal outcomes. The evidence adds important information to the current debate about the diagnostic criteria for GDM on pregnancy outcomes. Table. Adjusted odds ratios for pregnancy outcomes Variable Negative screening False-positive screening CC-only-GDM (not meeting NDDG) NDDG-GDM Neonatal Outcomes Macrosomia (>4,000 g)11.30( )2.73( )*3.15( )* Preterm labor (<37 weeks)11.09( )1.53( )1.90( )* Low birth weight (<2,500 g)11.07( )1.64( )*1.81( )* Admission to NICU a 11.02( )1.61( )*1.98( )* Apgar score <7 at 1 min10.78( )1.20( )1.13( ) Maternal Outcomes Cesarean section11.06( )1.11( )1.19( ) Gestational hypertension or preeclampsia11.36( )*1.42( )1.70( )* Shoulder dystocia b 10.61( )1.95( )2.02( ) Third- or fourth-degree perineal laceration b 11.04( )1.05( )0.98( ) Postpartum hemorrhage11.02( )1.26( )0.68( ) Data are presented as adjusted odds ratios (95% confidence intervals). Odds ratios were adjusted for nulliparity, maternal age, body mass index at delivery, and delivery year. In addition to the above confounding factors, the delivery type (Cesarean section or not) was added to be adjusted for the perinatal outcome of postpartum hemorrhage. CC=Carpenter-Coustan criteria; GDM=gestational diabetes mellitus; NDDG=National Diabetes Data Group criteria; NICU=neonatal intensive care unit a Excluded neonatal death b Only included vaginal delivery * 95% confidence interval did not include 1 P2.15