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The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus
Open accessAbstract
The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study was performed in response to the need for internationally agreed upon diagnostic criteria for gestational diabetes, based upon their predictive value for adverse pregnancy outcome. Increases in each of the 3 values on the 75-g, 2-hour oral glucose tolerance test are associated with graded increases in the likelihood of pregnancy outcomes such as large for gestational age, cesarean section, fetal insulin levels, and neonatal fat content. Based upon an iterative process of decision making, a task force of the International Association of Diabetes and Pregnancy Study Groups recommends that the diagnosis of gestational diabetes be made when any of the following 3 75-g, 2-hour oral glucose tolerance test thresholds are met or exceeded: fasting 92 mg/dL, 1-hour 180 mg/dL, or 2 hours 153 mg/dL. Various authoritative bodies around the world are expected to deliberate the adoption of these criteria.
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Zhao, L., Sheng, X., Zhou, S., Yang, T., Ma, L., Zhou, Y., & Cui, Y. (2015) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.12672 · Cited by 63
The role of genetics and epigenetics in the pathogenesis of gestational diabetes mellitus
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Application and Utility of Continuous Glucose Monitoring in Pregnancy: A Systematic Review
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“In thepast two decades, the incidence of GDMhas increased dramatically around world (Coustan et al., 2010).”
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“A recent study of 25,000 nondiabetic pregnancies collected from 9 countries observe that GDM is present in approximately 18 % of the studied pregnancies when careful diagnostic criteria are employed [48].”
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Rizzo, G., Garzon, S., Fichera, M., Panella, M. M., Catena, U., Schiattarella, A., FRANCISCIS, P. D., Vilos, G. A., Tesařík, J., Török, P., et al. (2019) · Antioxidants · doi:10.3390/antiox8110511 · Cited by 59
Georgiadis, L., Keski‐Nisula, L., Harju, M., Räisänen, S., Georgiadis, S., Hannila, M., & Heinonen, S. T. (2014) · Placenta · doi:10.1016/j.placenta.2014.02.001 · Cited by 55
“Moreover, the incidence of GDM has also increased due to increasing rates of maternal obesity [16,17].”
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“The diagnosis of GDM was defined according to the Hyperglycemia and Pregnancy Outcome (HAPO) criteria [20]: fasting glucose > 5.”
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Triunfo, S., Lanzone, A., & Lindqvist, P. G. (2017) · Journal of Endocrinological Investigation · doi:10.1007/s40618-017-0696-9 · Cited by 59
“In response to the need for internationally agreed upon diagnostic criteria for GDM, the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study was performed, based upon their predictive value for APO [29].”
InfluentialExposure to Endocrine-Disrupting Chemicals and Type 2 Diabetes Mellitus in Later Life
Lin, J., & Yin, R. (2022) · Exposure and Health · doi:10.1007/s12403-022-00486-0 · Cited by 55
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Exercise for pregnant women for preventing gestational diabetes mellitus
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“[DOI: 10.1111/ j.1464-5491.2011.03284.x] Coustan 2010 Coustan DR, Lowe LP, Metzger BE, Dyer AR.”
BackgroundInfluentialCubillos, G., Mönckeberg, M., Plaza, A., Morgan, M., Estévez, P. A., Choolani, M. A., Kemp, M. W., Illanes, S. E., & Perez, C. A. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05766-4 · Cited by 57
“A diagnosis of GDM was made using the IADPSG/HAPO criteria for gestational diabetes [13, 39], i.e., oral glucose tolerance test (75 g) fasting glycemia ≥ 92 mg/dl, or 2 h glycemia ≥ 153 mg/dl in the second trimester.”
MethodPlasencia, W., Delgado, R. G., Pereira, S., Akolekar, R., & Nicolaides, K. H. (2011) · Fetal Diagnosis and Therapy · doi:10.1159/000324684 · Cited by 51
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Jelsma, J. G. M., van Leeuwen, K. M., Oostdam, N., Bunn, C., Simmons, D. S., Desoyé, G., Corcoy, R., Adelantado, J. M., Kautzky‐Willer, A., Harreiter, J., et al. (2016) · Journal of Pregnancy · doi:10.1155/2016/3435791 · Cited by 50
Selective rather than universal screening for gestational diabetes mellitus?
Miailhe, G., Kayem, G., Girard, G., Legardeur, H., & Mandelbrot, L. (2015) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.05.003 · Cited by 51
“The institutional policy was the IADPSG universal 2-h screening with a 75 g oral glucose challenge test (OGTT) at 24–28 weeks gestational age [1,17].”
MethodInsulin for the treatment of women with gestational diabetes
Brown, J., Grzeskowiak, L. E., Williamson, K. A., Downie, M. R., & Crowther, C. A. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012037 · Cited by 52
Gestational diabetes mellitus: Taking it to heart
Marcinkevage, J. A., & Narayan, K. M. V. (2010) · Primary care diabetes · doi:10.1016/j.pcd.2010.10.002 · Cited by 49
Han, S., Crowther, C. A., & Middleton, P. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009037.pub2 · Cited by 49
Moullec, N. L., Fianu, A., Maillard, O., Chazelle, É., Naty, N., Schneebeli, C., Gérardin, P., Huiart, L., Charles, M.-A. A., & Favier, F. (2018) · PLoS ONE · doi:10.1371/journal.pone.0195531 · Cited by 49
First trimester gestational diabetes screening – Change in incidence and pharmacotherapy need
Alunni, M., Roeder, H., Moore, T. R., & Ramos, G. A. (2015) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2015.04.027 · Cited by 48
“[10] Coustan DR, Lowe LP, Metzger BE, Dyer AR.”
BackgroundResultWong, V., Lin, A., & Russell, H. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.04.018 · Cited by 45
Impact of risk factors for gestational diabetes (GDM) on pregnancy outcomes in women with GDM
Filardi, T., Tavaglione, F., Stasio, M. D., Fazio, V. M., Lenzi, A., & Morano, S. (2017) · Journal of Endocrinological Investigation · doi:10.1007/s40618-017-0791-y · Cited by 45
Impact of Sugary Food Consumption on Pregnancy: A Review
Casas, R. M., Castro‐Barquero, S., & Estruch, R. (2020) · Nutrients · doi:10.3390/nu12113574 · Cited by 51
“Up to 16% of pregnant women are diagnosed with GDM during pregnancy [74].”
BackgroundLiong, S., & Lappas, M. (2016) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2016.02.016 · Cited by 46
“INTRODUCTION 42 Gestational diabetes mellitus (GDM), defined as glucose intolerance with first onset during pregnancy, 44 affects up to 18% of all pregnant women (Coustan et al., 2010).”
BackgroundValsamakis, G., Papatheodorou, D. C., Chalarakis, N., Vrachnis, N., Sidiropoulou, E. J., Manolikaki, M., Mantzou, A., Margeli, A., Papassotiriou, I., Chrousos, G. P., et al. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.06.008 · Cited by 44
Neonatal outcomes according to different therapies for gestational diabetes mellitus
da Silva, A. L., do Amaral, A. R., Oliveira, D. S., Martins, L., Silva, M. R. E., & Silva, J. C. (2016) · Jornal de Pediatria · doi:10.1016/j.jped.2016.04.004 · Cited by 47
Shen, S., Lu, J., Zhang, L., He, J., Li, W., Chen, N., Wen, X., Xiao, W., Yuan, M., Qiu, L., et al. (2017) · EBioMedicine · doi:10.1016/j.ebiom.2017.01.025 · Cited by 40
“(Coustan et al., 2010).”
Zhang, Z., Wu, Y., Zhong, C., Zhou, X., Liu, C., Li, Q., Chen, R., Gao, Q. F., Li, X., Zhang, H., et al. (2021) · Nutrition · doi:10.1016/j.nut.2021.111193 · Cited by 45
Gestational Glucose Intolerance and Risk of Future Diabetes
Selen, D. J., Thaweethai, T., Schulte, C. C. M., Hsu, S. C., He, W. W., James, K. E., Kaimal, A. J., Meigs, J. B., & Powe, C. E. (2022) · Diabetes Care · doi:10.2337/dc22-1390 · Cited by 41
Tang, J. W., Foster, K. E., Pumarino, J., Ackermann, R. T., Peaceman, A. M., & Cameron, K. A. (2014) · Maternal and Child Health Journal · doi:10.1007/s10995-014-1657-y · Cited by 41
“During the study period, the clinics utilized a universal 1-step screening protocol for GDM (2 h 75 g glucose tolerance test) [29].”
MethodBertini, A., Gárate, B., Pardo, F., Pélicand, J., Sobrevía, L., Torres, R., Chabert, S., & Salas, R. (2022) · Frontiers in Bioengineering and Biotechnology · doi:10.3389/fbioe.2022.819697 · Cited by 42
“Ideally, the platform should be available in both forms (web page and mobile application), many of the studies reviewed used multiplatform applications, which is the most advantageous concerning the usability of the technology (Delia et al., 2015).”
BackgroundPapachatzopoulou, E., Chatzakis, C., Lambrinoudaki, I., Panoulis, K., Dinas, K., Vlahos, N., Sotiriadis, A., & Eleftheriades, M. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108048 · Cited by 40
Mussa, J., Meltzer, S., Bond, R., Garfield, N., & Dasgupta, K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18041454 · Cited by 42
“(d) the number of abnormal values required to warrant a GDM diagnosis [3].”
BackgroundKunysz, M., Mora-Janiszewska, O., & Darmochwał-Kolarz, D. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22094693 · Cited by 37
“Gestational diabetes is detected in approximately 15% of pregnancies [2].”
BackgroundPhysiological subtypes of gestational glucose intolerance and risk of adverse pregnancy outcomes
Selen, D. J., Edelson, P. K., James, K. E., Corelli, K., Hivert, M., Meigs, J. B., Thadhani, R., Ecker, J. L., & Powe, C. E. (2021) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2021.08.016 · Cited by 37
Prentice, P. M., Olga, L., Petry, C. J., Simmons, D. S., Murphy, H. R., Hughes, I. A., Acerini, C. L., Ong, K. K., & Dunger, D. B. (2019) · Diabetologia · doi:10.1007/s00125-019-4970-6 · Cited by 37
“glucose was positively correlated with increased birthweight, cord blood C-peptide level, neonatal hypoglycaemia and Caesarean section delivery rates [13, 14].”
MiRNAs in Gestational Diabetes Mellitus: Potential Mechanisms and Clinical Applications
Liu, Z., Jiang, Y., Liu, X.-Q., Yang, M., Chen, C., Zhao, B., Huang, H., & Luo, Q. (2021) · Journal of Diabetes Research · doi:10.1155/2021/4632745 · Cited by 39
Metadata
- Authors
- Coustan, D. R., Lowe, L. P., Metzger, B. E., & Dyer, A. R.
- Affiliations
- Brown University (US)
- Northwestern University (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2010-06
- Volume
- 202
- Issue
- 6
- Pages
- 654.e1-654.e6
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC2897007
- OpenAlex
- W2063955121
- Cited by
- 398
- References
- 16
- Citations by year
- 2026: 14 · 2025: 32 · 2024: 20 · 2023: 28 · 2022: 41 · 2021: 25 · 2020: 30 · 2019: 27 · 2018: 20 · 2017: 30 · 2016: 25 · 2015: 23 · 2014: 25 · 2013: 17 · 2012: 12
- FWCI
- 24.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-HD34242, R01-HD34243)
- National Center for Research Resources (M01-RR00048, M01-RR00080)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- American Diabetes Association
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- gestational diabetes mellitus, diagnostic criteria, HAPO study, oral glucose tolerance test, hyperglycemia, adverse pregnancy outcomes, large for gestational age, cesarean section, fetal insulin
- MeSH terms
- Blood Glucose, Female, Glucose Tolerance Test, Humans, Insulin, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Odds Ratio, Diabetes, Gestational
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