One-Step Screening for gestational diabetes Improves diagnoses but not outcomes
Researchers have found in a randomized trial that single-step" screening for gestational diabetes improved diagnoses but was not associated with improved maternal or neonatal outcomes.
The results of the trial were published in the New England Journal of Medicine.
Gestational diabetes was diagnosed twice as often with one-step screening (16.5% vs. 8.5% with two-step). However, there were no significant differences between the groups in the other primary outcomes, including large-for-gestational-age infant, a perinatal composite outcome (stillbirth, neonatal death, shoulder dystocia, bone fracture, or arm or hand nerve palsy), gestational hypertension or preeclampsia, or cesarean delivery.
There were no significant differences in health outcomes for pregnant women who were diagnosed with gestational diabetes or their babies using two different clinically recommended screening methods.
Although there is evidence that treating pregnant women for gestational diabetes leads to improved health outcomes for mothers and their infants, there is no scientific consensus on how best to screen for gestational diabetes. Two different approaches are recommended and used in clinical practice in the United States: a 1-step protocol that requires women to fast prior to the test (currently preferred by the American Diabetes Association) and a 2-step approach that does not require fasting for the initial test (currently recommended by the American College of Obstetricians and Gynecologists). This study was the first head-to-head trial comparing maternal and perinatal outcomes of the two methods.
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