Open AccessAre women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?
Author(s) -
Caissutti Claudia,
Khalifeh Adeeb,
Saccone Gabriele,
Berghella Vincenzo
Publication year - 2018
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13254
Subject(s) - medicine , gestational diabetes , preeclampsia , obstetrics , pregnancy , incidence (geometry) , fetal macrosomia , gestational hypertension , retrospective cohort study , gestational age , diabetes mellitus , randomized controlled trial , gynecology , gestation , endocrinology , genetics , physics , optics , biology
The aim of this study was to evaluate if women meeting criteria for gestational diabetes mellitus ( GDM ) by the One Step test as per International Association of the Diabetes and Pregnancy Study Groups ( IADPSG ) criteria but not by other less strict criteria have adverse pregnancy outcomes compared with GDM ‐negative controls. The primary outcome was the incidence of macrosomia, defined as birthweight > 4000 g. Material and methods Electronic databases were searched from their inception until May 2017. All studies identifying pregnant women negative at the Two Step test, but positive at the One Step test for IADPSG criteria were included. We excluded studies that randomized women to the One Step vs. the Two Step tests; studies that compared different criteria within the same screening method; randomized studies comparing treatments for GDM ; and studies comparing incidence of GDM in women doing the One Step test vs. the Two Step test. Results Eight retrospective cohort studies, including 29 983 women, were included. Five study groups and four control groups were identified. The heterogeneity between the studies was high. Gestational hypertension, preeclampsia and large for gestational age, as well as in some analyses cesarean delivery, macrosomia and preterm birth, were significantly more frequent, and small for gestational age in some analyses significantly less frequent, in women GDM ‐positive by the One Step, but not the Two Step. Conclusion Women meeting criteria for GDM by IADPSG criteria but not by other less strict criteria have an increased risk of adverse pregnancy outcomes such as gestational hypertension, preeclampsia and large for gestational age, compared with GDM ‐negative controls. Based on these findings, and evidence from other studies that treatment decreases these adverse outcomes, we suggest screening for GDM using the One Step IADPSG criteria.