Comparison of universal screening for gestational diabetes mellitus between one‐step and two‐step method among Thai pregnant women: A randomized control trial
Year: 2024
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: AIMS: To compare the prevalence of GDM and pregnancy outcomes between the one-step and two-step methods of universal screening among Thai pregnant women. METHODS: A randomized controlled trial was conducted on singleton Thai pregnant women at a gestational age of 24-28 weeks. They were randomly assigned to either the one-step method group (a universal 75-gm 2-h oral glucose tolerance test: OGTT) or the two-step method group (a universal 50-gm oral glucose challenge test followed by a 100-gm 3-h OGTT). The women received standard antenatal care. The prevalence of GDM and obstetric outcomes were compared. RESULTS: A total of 143 women meeting the inclusion criteria were randomly allocated into the one-step group (72 cases) and the two-step group (71 cases). The prevalence of GDM was significantly higher in the one-step group than in the two-step group, with rates of 24/73 (33.3%) vs 8/70 (11.3%); P value 0.002; relative risk of 2.96, 95% CI: 1.43-6.14, respectively. Demographic data and maternal and neonatal outcomes were comparable between the two groups. CONCLUSIONS: The one-step method can markedly increase the prevalence of GDM to nearly three times that of the two-step method, leading to a substantial increase in care costs and burdens without clear benefits. Convincingly, the one-step method as a new approach may not be suitable for universal screening in a busy antenatal care setting, especially in low-resource health centers in developing countries or among populations with a high prevalence of GDM.
DOI: 10.1111/jdi.14370
Institution: Chiang Mai University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,850
OpenAlex ID: W4404821281