Comparison of universal screening for gestational diabetes mellitus between one-step and two-step method among Thai pregnant women: A randomized control trial.

IF 3.2 3区 医学
Natthaphon Phoblap, Phudit Jatavan, Theera Tongsong
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引用次数: 0

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.

泰国孕妇妊娠糖尿病普查一步法与两步法的比较:随机对照试验。
目的:比较在泰国孕妇中采用一步法和两步法进行普遍筛查的 GDM 患病率和妊娠结局:对孕龄为 24-28 周的泰国单胎孕妇进行了随机对照试验。她们被随机分配到一步法组(通用的 75 克 2 小时口服葡萄糖耐量试验:OGTT)或两步法组(通用的 50 克口服葡萄糖挑战试验,然后进行 100 克 3 小时 OGTT)。这些妇女都接受了标准的产前护理。对 GDM 的患病率和产科结果进行了比较:符合纳入标准的 143 名产妇被随机分配到一步法组(72 例)和两步法组(71 例)。一步法组的 GDM 患病率明显高于两步法组,分别为 24/73 (33.3%) vs 8/70 (11.3%);P 值为 0.002;相对风险为 2.96,95% CI:1.43-6.14。两组的人口统计学数据、孕产妇和新生儿结局具有可比性:结论:一步法可明显增加 GDM 的患病率,使其接近两步法的三倍,导致护理成本和负担大幅增加,却没有明显的益处。令人信服的是,一步法作为一种新方法可能并不适合在繁忙的产前护理环境中进行普遍筛查,尤其是在发展中国家资源匮乏的医疗中心或 GDM 患病率较高的人群中。
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来源期刊
Journal of Diabetes Investigation
Journal of Diabetes Investigation Medicine-Internal Medicine
自引率
9.40%
发文量
218
期刊介绍: Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).
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