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. 2016;29(7):1141-5.
doi: 10.3109/14767058.2015.1038513. Epub 2015 May 11.

The effect of adopting the IADPSG screening guidelines on the risk profile and outcomes of the gestational diabetes population

Melissa I March  1   2   3 , Anna M Modest  1 , Steven J Ralston  1   2   3 , Michele R Hacker  1   3 , Munish Gupta  4   5 , Florence M Brown  6   7   8
Affiliations

The effect of adopting the IADPSG screening guidelines on the risk profile and outcomes of the gestational diabetes population

Melissa I March et al. J Matern Fetal Neonatal Med. 2016.

Abstract

Objective: To compare characteristics and outcomes of women diagnosed with gestational diabetes mellitus (GDM) by the newer one-step glucose tolerance test and those diagnosed with the traditional two-step method.

Research design and methods: This was a retrospective cohort study of women with GDM who delivered in 2010-2011. Data are reported as proportion or median (interquartile range) and were compared using a Chi-square, Fisher's exact or Wilcoxon rank sum test based on data type.

Results: Of 235 women with GDM, 55.7% were diagnosed using the two-step method and 44.3% with the one-step method. The groups had similar demographics and GDM risk factors. The two-step method group was diagnosed with GDM one week later [27.0 (24.0-29.0) weeks versus 26.0 (24.0-28.0 weeks); p = 0.13]. The groups had similar median weight gain per week before diagnosis. After diagnosis, women in the one-step method group had significantly higher median weight gain per week [0.67 pounds/week (0.31-1.0) versus 0.56 pounds/week (0.15-0.89); p = 0.047]. In the one-step method group more women had suspected macrosomia (11.7% versus 5.3%, p = 0.07) and more neonates had a birth weight >4000 g (13.6% versus 7.5%, p = 0.13); however, these differences were not statistically significant. Other pregnancy and neonatal complications were similar.

Conclusions: Women diagnosed with the one-step method gained more weight per week after GDM diagnosis and had a non-statistically significant increased risk for suspected macrosomia. Our data suggest the one-step method identifies women with at least equally high risk as the two-step method.

Keywords: Diagnosis; gestational diabetes; outcomes; risk profile.

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References

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