There were no differences in LGA neonates between the one-step and two-step groups
Risk reduction 0.90 (97.5% CI, 0.53 to 1.52)
Among women without GDM
Risk reduction 0.85 (97.5% CI, 0.49 to 1.48)
Those screened with the one-step approach had higher rates of neonatal morbidity (composite outcome) but fewer study-related adverse events (e.g., testing related hypoglycemia, nausea and vomiting)
There were no significant differences between the groups in rates of
Maternal morbidity composite
The use of the one-step GDM screening method increased the number of GDM diagnoses, but did not reduce the number of LGA neonates or maternal or neonatal morbidity
Study limitations include
Study not powered to compare LGA between women with GDM in each group (would require 10,000 participants per arm)
If only the IADPSG criteria were used the 50-g OGTT would not have been necessary
The authors state
The results of the GDM2 trial provide evidence that the IADPSG criteria for diagnosing GDM increase the use of health care resources but do not reduce the risk of LGA birth weight or other pregnancy-related morbidities compared with the Carpenter-Coustan criteria
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