title: Utilization of International Association of Diabetes and Pregnancy Study Groups criteria vs. a two-step approach to screening for gestational diabetes mellitus in Chinese women with twin pregnancies.
abstract: OBJECTIVE
  To evaluate prevalence and pregnancy outcomes using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and screening protocol vs. a standard two-step screening approach for gestational diabetes mellitus in Chinese twin pregnancies.
  
  
  METHODS
  A retrospective cohort study for pregnancies during 2007-2013 was performed in a tertiary hospital in Shanghai, China. Data were abstracted from the medical records of twin pregnancies delivered at the hospital. During the period 2007-2011, this hospital used a two-step approach with a 50 g screening with a cut-off value of ≥ 7.8 mmol/l followed by a 100 g diagnostic oral glucose tolerance test (OGTT) utilizing Carpenter-Coustan criteria. In 2012-2013, the hospital switched to the IADPSG protocol of universal 75 g OGTT.
  
  
  RESULTS
  Among 1461 twin pregnancies, 643 were screened utilizing IADPSG criteria and 818 using the two-step protocol. Gestational diabetes mellitus was diagnosed more frequently in the IADPSG group than in the two-step group [20.4% and 7.0%, respectively; adjusted odds ratio (aOR) = 3.22; 95% confidence interval (CI) = 2.30-4.52]. During the IADPSG period, the incidence of pre-eclampsia was 38% lower in non-gestational diabetes mellitus affected pregnancies compared with the two-step period (aOR = 0.62; 95% CI = 0.44-0.87). We observed no significant differences in most perinatal outcomes between the two groups.
  
  
  CONCLUSIONS
  Compared with a standard two-step approach to screening and diagnosis, the IADPSG screening method resulted in a three-fold increase in the incidence of gestational diabetes mellitus in twin pregnancies, with a 38% lower risk of pre-eclampsia but no significant difference in most perinatal outcomes in non-gestational diabetes mellitus affected pregnancies.
authors.affiliation: Obstetrics Department, International Peace Maternity & Child Health Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.forename: Q
authors.initials: Q
authors.lastname: Zhou
authors.forename: H
authors.initials: H
authors.lastname: Shi
authors.forename: W W
authors.initials: WW
authors.lastname: Cheng
mesh_terms: D000328:Adult; D044466:Asian People; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D007390:International Agencies; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors