Maternal and neonatal outcomes according to the timing of diagnosis of gestational diabetes: A critical appraisal

Core Tip

Core Tip: Gestational diabetes mellitus (GDM) is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses. Hyperglycemia that satisfies the GDM diagnostic criteria is increasingly being identified in early pregnancy [early-onset GDM (E-GDM)]. Despite treatment, adverse pregnancy events are more common in E-GDM than in late-onset GDM. The TOBOGM study revealed a significant reduction in adverse neonatal events, especially neonatal respiratory distress syndrome, when GDM treatment was initiated in early pregnancy and reported the cost-effectiveness of this strategy. More prospective randomized controlled trials are needed to develop an internationally accepted criterion for E-GDM diagnosis.