Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?

Khalifeh, Adeeb; Saccone, Gabriele; Berghella, Vincenzo

doi:10.1111/aogs.13254

Cited by 26 publications

(11 citation statements)

References 36 publications

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“…Therefore, these data cannot be used to ascertain whether adoption of the IADPSG criteria would identify women who otherwise have adverse perinatal outcomes in real‐world clinical care. A recent systematic review of eight studies including nearly 30 000 women examined pregnancy outcomes for women who met IADPSG but not less strict criteria for GDM . The results were similar to our findings: these women had a higher risk for hypertensive disorders of pregnancy, preterm birth, caesarean delivery and large‐for‐gestational‐age compared with women without GDM.…”

Section: Discussionsupporting

confidence: 87%

“…Finally, we used a population‐based sample of women cared for in diverse settings and with diverse care pathways that is more generalisable than previous research that has predominantly examined data from a single centre. Indeed, the number of patients included in our study was more than triple the total number of patients included in a recent systematic review . These strengths make this study an important contribution to the existing literature.…”

Section: Discussionmentioning

confidence: 93%

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Perinatal outcomes for untreated women with gestational diabetes by IADPSG criteria: a population‐based study

Shah

Sharifi

2019

BJOG

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Objective To estimate the risk for adverse perinatal outcomes for women who met the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria but not the two‐step criteria for gestational diabetes mellitus (GDM). Design Population‐level cross‐sectional study. Setting Ontario, Canada. Population A total of 90 140 women who underwent a 75‐g oral glucose tolerance test. Methods Women were divided into those who met the diagnostic thresholds for GDM by two‐step criteria and were therefore treated, those who met only the IADPSG criteria for GDM and so were not treated, and those who did not have GDM by either criteria. Main outcome measures Hypertensive disorders of pregnancy, preterm delivery, primary caesarean section, large‐for‐gestational‐age, shoulder dystocia and neonatal intensive care unit admission. Results Women who met the IADPSG criteria had an increased risk for all adverse perinatal outcomes compared with women who did not have GDM. Women with GDM by two‐step criteria also had an increased risk of most outcomes. However, their risk for large‐for‐gestational‐age neonates and for shoulder dystocia was actually lower than that of women who met IADPSG criteria. Conclusion Women who met IADPSG criteria but who were not diagnosed with GDM based on the current two‐step diagnostic strategy, and were therefore not treated, had an increased risk for adverse perinatal outcomes compared with women who do not have GDM. The current strategy for diagnosing GDM may be leaving women who are at risk for adverse events without the dietary and pharmacological treatments that could improve their pregnancy outcomes. Tweetable abstract Women who meet IADPSG criteria for GDM have an increased risk for adverse perinatal outcomes compared with women without GDM.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 93%

Perinatal outcomes for untreated women with gestational diabetes by IADPSG criteria: a population‐based study

Shah

Sharifi

2019

BJOG

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“…Overall, the 75-g two-hour test is more practical and convenient compared with the 100-g three-hour test. Furthermore, it appears to be more sensitive in predicting the pregnancy’s complication like gestational hypertension, preeclampsia and macrosomia than the 100-g three-hour test [61]. The reason for increased sensitivity is mainly that only one elevated glucose value is needed to diagnose GDM in 75-g two-hour test compared to 100-g three-hour test which requires two abnormal glucose values [60].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis

Lee

Ching

Ramachandran

et al. 2018

BMC Pregnancy Childbirth

387

273

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BackgroundGestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis.MethodsWe systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI).ResultsEighty-four studies with STROBE score ≥ 14 were included in our analysis. The pooled prevalence of GDM in Asia was 11.5% (95% CI 10.9–12.1). There was considerable heterogeneity (I2 > 95%) in the prevalence of GDM in Asia, which is likely due to differences in diagnostic criteria, screening methods and study setting. Meta-analysis demonstrated that the risk factors of GDM include history of previous GDM (OR 8.42, 95% CI 5.35–13.23); macrosomia (OR 4.41, 95% CI 3.09–6.31); and congenital anomalies (OR 4.25, 95% CI 1.52–11.88). Other risk factors include a BMI ≥25 kg/m2 (OR 3.27, 95% CI 2.81–3.80); pregnancy-induced hypertension (OR 3.20, 95% CI 2.19–4.68); family history of diabetes (OR 2.77, 2.22–3.47); history of stillbirth (OR 2.39, 95% CI 1.68–3.40); polycystic ovary syndrome (OR 2.33, 95% CI1.72–3.17); history of abortion (OR 2.25, 95% CI 1.54–3.29); age ≥ 25 (OR 2.17, 95% CI 1.96–2.41); multiparity ≥2 (OR 1.37, 95% CI 1.24–1.52); and history of preterm delivery (OR 1.93, 95% CI 1.21–3.07).ConclusionWe found a high prevalence of GDM among the Asian population. Asian women with common risk factors especially among those with history of previous GDM, congenital anomalies or macrosomia should receive additional attention from physician as high-risk cases for GDM in pregnancy.Trial registrationPROSPERO (2017: CRD42017070104).

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“…If one result was found to be more than the glucose cut-off value (fasting: 92 mg/dL, first hour: 180 mg/dL, and second hour: 153 mg/dL) GDM is diagnosed. Carpenter -Coustan, NDDG, and O’Sullivan- Mahan criteria use a 3 h with 100 g glucose loading approach [ 26 ] with different cut-off values. GDM is confirmed when any two results exceed than thresholds [ 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

Association of circulating omega 3, 6 and 9 fatty acids with gestational diabetes mellitus: a systematic review

et al. 2021

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Background Gestational diabetes mellitus (GDM) is associated with increased risks of disease for mother and child during pregnancy and after that. Early diagnosis of GDM would promote both maternal and fetal health. Metabolomics can simplify and develop our understanding of the etiology, manifestation, or pathophysiology of the disease. This systematic review investigates the association of circulating omega 3, 6, and 9 fatty acids with GDM. Methods We conducted a systematic search of PubMed, Scopus, Web of Science, and EMBASE databases up to May 8, 2020, using the key term combinations of all types of omega fatty acids with gestational diabetes mellitus. Additional articles were identified through searching the reference lists of included studies. Results This systematic review included 15 articles. Five were cohort studies, four included nested case-control studies and four were case-control studies. The results of this study demonstrate an increasing trend in the amount of oleic acid and palmitoleic acid in the second trimester and an increase in decosahexanoic acid in the third trimester of GDM mothers. The changes in other fatty acids of interest are either not significant or if significant, their results are inconsistent with the other existing articles. Conclusions Omega fatty acids, as potential biomarkers, are considered to be associated with GDM risk and thus provide useful information regarding the prevention and early diagnosis of GDM. Moreover, existing metabolomic studies on GDM are shown to provide conflicting results about metabolite profile characteristics. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42020196122.

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Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?

Cited by 26 publications

References 36 publications

Perinatal outcomes for untreated women with gestational diabetes by IADPSG criteria: a population‐based study

Perinatal outcomes for untreated women with gestational diabetes by IADPSG criteria: a population‐based study

Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis

Association of circulating omega 3, 6 and 9 fatty acids with gestational diabetes mellitus: a systematic review

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