Early gestational diabetes screening in women at risk for gestational diabetes: a randomized controlled trial

Alejandro Rodriguez, MD, assistant professor, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida along with 3 other investigators, evaluated the impact of early glucose screening and treatment on high risk individuals.

Florida participants were chosen based on ACOG’s practice bulletin risk factors for GDM. Inclusion data included pregnant patients between 18 and 45 years of age with 1 or more of the following risk factors: obesity; history of prior pregnancy complicated by GDM; history of prior pregnancy complicated by macrosomia; first degree relative with diabetes; and multiple gestation.

Strengths of this study included that it was both randomized and clinical, which would add to the paucity of literature on this subject with standardized diagnosis and management plans.

Participants were randomized into 2 screening groups: glucose screen at 12-18 weeks’ (early) or at 24-28 weeks’ (usual care). Two-step screening was performed with gestational diabetes diagnosed using Carpenter−Coustan criteria. Women with a negative test at 12-18 weeks’ were rescreened at 24 to 28 weeks. All patients diagnosed with GDM were treated following institutional protocols.

Primary outcomes were a composite of adverse perinatal outcomes, including perinatal mortality; neonatal hypogkycemia; addmision to a NICU; hyperbilirubinemia; and birth trauma, with a secondary outcome of maternal gestational weight gain.

The authors concluded that early glucose screening in women at high risk for gestational diabetes was not associated with improved perinatal outcomes.

Reference

Rodriguez A, Delgado A, Pressman K, Louis JM. Early gestational diabetes screening in women at risk for gestational diabetes: a randomized controlled trial. Oral concurrent session. Society for Maternal-Fetal Medicine 42nd Annual Pregnancy Meeting. Virtual. February 4, 2022.