Perinatal outcomes after adopting 1- versus 2-step approach to diagnosing gestational diabetes
| Autor: | Kathryn Davidson, Oluseyi Ogunleye, Robert Egerman, Anthony R. Gregg |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty 030209 endocrinology & metabolism Gestational Age 03 medical and health sciences 0302 clinical medicine Pregnancy Diabetes mellitus medicine Prevalence Glucose challenge test Humans 030212 general & internal medicine Retrospective Studies Gynecology Glucose tolerance test medicine.diagnostic_test Obstetrics business.industry Incidence (epidemiology) Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Gestational age Retrospective cohort study Glucose Tolerance Test medicine.disease Gestational diabetes Diabetes Gestational Pediatrics Perinatology and Child Health Practice Guidelines as Topic Female business |
| Zdroj: | The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 30(2) |
| ISSN: | 1476-4954 |
| Popis: | The American College of Obstetricians and Gynecologists (ACOG) and the IADPSG (International Association of Diabetes and Pregnancy Study Groups) proposed distinct approaches to diagnosing gestational diabetes mellitus (GDM). We sought to analyze these paradigms: (1) ACOG 2-step approach where screening is followed by diagnostic testing, (2) IADPSG 1-step diagnostic testing.We reviewed data from pregnant women (24-28 wks) screened for GDM over two periods: (1) November 2011-May 2012 (2) November 2012-May 2013. Period 1: 2-step approach (screening 1-h glucose challenge test (GCT) followed by a diagnostic 3-h 100-g glucose tolerance test (GTT) when abnormal (≥140 mg/dl)). Period 2: an abnormal value after a 2-h 75-g GTT result was diagnostic of GDM. We compared the incidence of GDM and perinatal outcomes using either approach.Out of 471 patients screened by ACOG 2-step approach, 72 (15.3%) had an abnormal 1-h screening and underwent the 3-h diagnostic GTT, and 26 (5.5%) developed GDM. The 1-step approach resulted in 53 (15.96%) with GDM of a total 332 evaluated. There was no statistically significant difference in perinatal outcomes between the two cohorts. Maternal weight at the start and the end of pregnancy was greater for patients diagnosed by the ACOG 2-step approach.Adopting 1-step approach (ADA) to diagnose GDM resulted in a 3-fold increase in prevalence of GDM with no differences in perinatal outcomes. |
| Databáze: | OpenAIRE |
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