title: The effect of adopting the IADPSG screening guidelines on the risk profile and outcomes of the gestational diabetes population.
abstract: OBJECTIVE
  To compare characteristics and outcomes of women diagnosed with gestational diabetes mellitus (GDM) by the newer one-step glucose tolerance test and those diagnosed with the traditional two-step method.
  
  
  METHODS
  This was a retrospective cohort study of women with GDM who delivered in 2010-2011. Data are reported as proportion or median (interquartile range) and were compared using a Chi-square, Fisher's exact or Wilcoxon rank sum test based on data type.
  
  
  RESULTS
  Of 235 women with GDM, 55.7% were diagnosed using the two-step method and 44.3% with the one-step method. The groups had similar demographics and GDM risk factors. The two-step method group was diagnosed with GDM one week later [27.0 (24.0-29.0) weeks versus 26.0 (24.0-28.0 weeks); p = 0.13]. The groups had similar median weight gain per week before diagnosis. After diagnosis, women in the one-step method group had significantly higher median weight gain per week [0.67 pounds/week (0.31-1.0) versus 0.56 pounds/week (0.15-0.89); p = 0.047]. In the one-step method group more women had suspected macrosomia (11.7% versus 5.3%, p = 0.07) and more neonates had a birth weight >4000 g (13.6% versus 7.5%, p = 0.13); however, these differences were not statistically significant. Other pregnancy and neonatal complications were similar.
  
  
  CONCLUSIONS
  Women diagnosed with the one-step method gained more weight per week after GDM diagnosis and had a non-statistically significant increased risk for suspected macrosomia. Our data suggest the one-step method identifies women with at least equally high risk as the two-step method.
authors.affiliation: a Department of Obstetrics and Gynecology and.|b Division of Maternal Fetal Medicine , Beth Israel Deaconess Medical Center , Boston , MA , USA .|c Department of Obstetrics, Gynecology and Reproductive Biology , Harvard Medical School , Boston , MA , USA .
authors.forename: Melissa I
authors.initials: MI
authors.lastname: March
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Modest
authors.affiliation: a Department of Obstetrics and Gynecology and.|b Division of Maternal Fetal Medicine , Beth Israel Deaconess Medical Center , Boston , MA , USA .|c Department of Obstetrics, Gynecology and Reproductive Biology , Harvard Medical School , Boston , MA , USA .
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Ralston
authors.affiliation: a Department of Obstetrics and Gynecology and.|c Department of Obstetrics, Gynecology and Reproductive Biology , Harvard Medical School , Boston , MA , USA .
authors.forename: Michele R
authors.initials: MR
authors.lastname: Hacker
authors.affiliation: d Department of Neonatology , Beth Israel Deaconess Medical Center , Boston , MA , USA .|e Department of Pediatrics , Harvard Medical School , Boston , MA , USA .
authors.forename: Munish
authors.initials: M
authors.lastname: Gupta
authors.affiliation: f Department of Internal Medicine , Beth Israel Deaconess Medical Center , Boston , MA , USA .|g Joslin Diabetes Center , Boston , MA , USA , and.|h Department of Medicine , Harvard Medical School , Boston , MA , USA.
authors.forename: Florence M
authors.initials: FM
authors.lastname: Brown
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005951:Glucose Tolerance Test; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening / Q000379:methods / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology; D011296:Prenatal Diagnosis / Q000379:methods / Q000592:standards*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Diagnosis; gestational diabetes; outcomes; risk profile