Various screening and diagnosis approaches for gestational diabetes mellitus and adverse pregnancy outcomes: a secondary analysis of a randomized non-inferiority field trial
BMJ Open Diabetes Res CarePublished Secondary analysis of a randomised community non-inferiority field trial
We conclude that screening approaches for GDM reduced the risk of adverse pregnancy outcomes to the same or near the same risk level of healthy pregnant women, except for the risk of NICU admission that increased significantly in groups diagnosed with GDM compared with healthy pregnant women. Individuals with slight increase in FPG (92-100 mg/dL) at first trimester, who were diagnosed as GDM, had an even increased risk of macrosomia in comparison to those group of women with FPG 92-100 mg/dL in the first trimester, who were not diagnosed with GDM, and developed GDM in second trimester
Study context
Population
Pregnant women participating in the GULF Study in Iran5 screening protocols
Participants
35,430 women
Comparison
Gestational diabetes mellitus (GDM) screening/diagnosis categories by first-trimester fasting plasma glucose (FPG) and second-trimester one-step or two-step screening
Primary endpoint
Major adverse maternal and neonatal outcomes
Methodological detailsGULF Study, randomized, five prespecified GDM screening protocols
GULF Study
Randomized
Five prespecified GDM screening protocols
Primary result
As reported in the abstract
Group
Value
Primary caesarean section
Group 1
9.8%
21.0%
Group 2
7.8%
19.8%
Group 3
5.4%
18.6%
Group 4
6.6%
21.5%
Group 5
8.3%
24.0%
Group 6
5.4%
20.0%
Value
Group 19.8%
Group 27.8%
Group 35.4%
Group 46.6%
Group 58.3%
Group 65.4%
Primary caesarean section
Group 121.0%
Group 219.8%
Group 318.6%
Group 421.5%
Group 524.0%
Group 620.0%
Original publication
Various screening and diagnosis approaches for gestational diabetes mellitus and adverse pregnancy outcomes: a secondary analysis of a randomized non-inferiority field trial. BMJ Open Diabetes Res Care. Published 12 December 2023. doi:10.1136/bmjdrc-2023-003510