Perinatal Outcomes of Two Screening Strategies for Gestational Diabetes Mellitus: A Randomized Controlled Trial
dc.contributor.author | Davis, Esa M. | |
dc.contributor.author | Abebe, Kaleab Z. | |
dc.contributor.author | Simhan, Hyagriv N. | |
dc.contributor.author | Catalano, Patrick | |
dc.contributor.author | Costacou, Tina | |
dc.contributor.author | Comer, Diane | |
dc.contributor.author | Orris, Steven | |
dc.contributor.author | Ly, Kathleen | |
dc.contributor.author | Decker, Alison | |
dc.contributor.author | Mendez, Dara | |
dc.contributor.author | Day, Nancy | |
dc.contributor.author | Scifres, Christina M. | |
dc.contributor.department | Obstetrics and Gynecology, School of Medicine | |
dc.date.accessioned | 2023-08-02T12:16:51Z | |
dc.date.available | 2023-08-02T12:16:51Z | |
dc.date.issued | 2021 | |
dc.description.abstract | Objective: To evaluate differences in short-term perinatal outcomes between the two prominent screening strategies for gestational diabetes mellitus, the International Association of Diabetes and Pregnancy Study Groups (IADPSG) and Carpenter-Coustan. Methods: In this single-site, blinded, randomized, comparative effectiveness trial, participants received a nonfasting 50-g oral glucose tolerance test and, if less than 200 mg/dL (less than 11.1 mmol/L), were randomized to further screening with either IADPSG or Carpenter-Coustan criteria. Gestational diabetes treatment occurred per routine clinical care. The primary outcome was incidence of large-for-gestational-age (LGA) neonates. Prespecified secondary outcomes included small-for-gestational-age (SGA) neonates, cesarean birth, and neonatal and maternal composites of adverse perinatal outcomes. Assuming a 15% incidence of LGA neonates in the Carpenter-Coustan group, 782 participants provided more than 80% power to detect a 7% absolute risk reduction with the use of IADPSG; planned recruitment was 920 for anticipated attrition. Results: From June 2015 to February 2019, 1,016 participants were enrolled and 921 were randomized to IADPSG (n=461) or Carpenter-Coustan (n=460) groups. Gestational diabetes incidence (14.4% vs 4.5%, P<.001) and diabetes medication use (9.3% vs 2.4%; P<.001) were more common in the IADPSG group; there were no differences in LGA neonates, either overall (risk reduction 0.90, 97.5% CI 0.53-1.52) or among women without gestational diabetes (risk reduction 0.85, 97.5% CI 0.49-1.48). Those screened with IADPSG had higher rates of neonatal morbidity but fewer study-related adverse events. Rates of SGA neonates, cesarean birth, and maternal morbidity composite did not differ significantly between study groups. Conclusions: The IADPSG screening criteria resulted in more women diagnosed and treated for gestational diabetes than Carpenter-Coustan without reducing the incidence of LGA birth weight or maternal or neonatal morbidity. | |
dc.eprint.version | Author's manuscript | |
dc.identifier.citation | Davis EM, Abebe KZ, Simhan HN, et al. Perinatal Outcomes of Two Screening Strategies for Gestational Diabetes Mellitus: A Randomized Controlled Trial. Obstet Gynecol. 2021;138(1):6-15. doi:10.1097/AOG.0000000000004431 | |
dc.identifier.uri | https://hdl.handle.net/1805/34674 | |
dc.language.iso | en_US | |
dc.publisher | Wolters Kluwer | |
dc.relation.isversionof | 10.1097/AOG.0000000000004431 | |
dc.relation.journal | Obstetrics & Gynecology | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Gestational diabetes | |
dc.subject | Fetal macrosomia | |
dc.subject | Newborn infant | |
dc.subject | Mass screening | |
dc.subject | Pregnancy outcome | |
dc.title | Perinatal Outcomes of Two Screening Strategies for Gestational Diabetes Mellitus: A Randomized Controlled Trial | |
dc.type | Article |