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Time to Completion of Two-Step Screening for Gestational Diabetes and Adverse Outcomes.
- Source :
-
American journal of perinatology [Am J Perinatol] 2024 May; Vol. 41 (S 01), pp. e2679-e2685. Date of Electronic Publication: 2023 Aug 01. - Publication Year :
- 2024
-
Abstract
- Objective: This study aimed to ascertain whether the length of time to complete the gestational diabetes mellitus (GDM) screening was associated with adverse neonatal outcomes.<br />Study Design: This was a retrospective cohort study of singleton, nonanomalous individuals who were screened for GDM at ≥24 weeks' gestation at an academic hospital system. We compared outcomes among people who were diagnosed with GDM and completed the 3-hour glucose tolerance test (GTT) ≤14 second versus >14 days from the 1-hour glucose challenge test (GCT). The primary outcome was a composite adverse neonatal outcome of the following: large for gestational age, shoulder dystocia, birth injury, respiratory distress, hypoglycemia, or fetal/neonatal death. The secondary outcomes included several individual neonatal and maternal morbidities. Multivariable Poisson's regression models were used to evaluate the association. Adjusted relative risk (aRR) and 95% confidence intervals (CI) were calculated.<br />Results: Among the 313 individuals who completed the two-step screening for GDM and had an 1-hour GCT ≥ 135 mg/dL; of them, 171 (54.6%) completed the 3-hour GTT ≤14 days, 142 (45.4%) completed the 3-hour GTT > 14 days. Overall rate of the primary outcome was 44.1%. After multivariable adjustment, the risk of the primary outcome was similar between people who completed the two-step method in ≤14 versus >14 days (aRR = 1.11, 95% CI = 0.81-1.52). There was no significant difference in all secondary adverse outcomes between the two groups. Subgroup analyses, limited to people diagnosed with GDM ( N = 89, 23.4%), also found similar results as the full analyses.<br />Conclusion: Among individuals who completed the two-step screening for GDM, completion of the 3-hour GTT within ≤14 versus ≥ 14 days was not associated with an increase rate of the adverse outcomes.<br />Key Points: · Among pregnant people in an academic practice, 50% of people with abnormal 1-hour GTT completed GDM two-step screening in 14 days.. · Longer length of time to completion of diagnostic testing for GDM was not associated with an increased rate of adverse outcomes.. · Pregnant people that were diagnosed with GDM and completed the two-step method in >14 days did not have worse perinatal outcomes..<br />Competing Interests: None declared.<br /> (Thieme. All rights reserved.)
- Subjects :
- Humans
Female
Pregnancy
Retrospective Studies
Adult
Time Factors
Infant, Newborn
Mass Screening methods
Pregnancy Outcome
Shoulder Dystocia epidemiology
Shoulder Dystocia diagnosis
Hypoglycemia diagnosis
Hypoglycemia epidemiology
Fetal Macrosomia epidemiology
Gestational Age
Multivariate Analysis
Diabetes, Gestational diagnosis
Diabetes, Gestational epidemiology
Glucose Tolerance Test
Subjects
Details
- Language :
- English
- ISSN :
- 1098-8785
- Volume :
- 41
- Issue :
- S 01
- Database :
- MEDLINE
- Journal :
- American journal of perinatology
- Publication Type :
- Academic Journal
- Accession number :
- 37527789
- Full Text :
- https://doi.org/10.1055/a-2145-7899