One-step vs. two-step gestational diabetes mellitus screening and pregnancy outcomes : an updated systematic review and meta-analysis
Copyright © 2024. Published by Elsevier Inc..
OBJECTIVE: We performed a systematic review and meta-analysis comparing maternal and neonatal outcomes of patients screened with one-step or two-step screening methods for GDM.
DATA SOURCES: Pubmed, Scopus, Cochrane, ClinicalTrials.gov, and LILACS were searched from inception up to September 2022.
STUDY ELIGIBILITY CRITERIA: Only randomized controlled trials (RCTs) were included. Studies that had overlapping populations were excluded (PROSPERO CRD42022358903).
STUDY APPRAISAL AND SYNTHESIS METHODS: Risk ratios (RR) were computed with 95% confidence intervals (CI) by two authors. Unpublished data were requested. Large for gestational age (LGA) was the primary outcome.
RESULTS: The search yielded 394 citations. Seven RCTs met inclusion criteria. A total of 54,650 participants were screened for GDM by either the one-step method (N=27,163) or the two-step method (N=27,487). For LGA, there were no significant differences found between groups (RR 0.99; 95% CI 0.93-1.05; I2=0%). Newborns of patients in one-step testing had higher rates of neonatal hypoglycemia (RR 1.24; 95% CI 1.14-1.34; I2 =0%) and NICU admissions (RR 1.13; 95% CI 1.04-1.21; I2=0%). Patients in the one-step group were more likely to be diagnosed with GDM (RR 1.73; 95% CI 1.44-2.09; I2=80%). In addition, among trials that tested all patients prior to and excluded patients with pregestational diabetes, newborns were more likely to have macrosomia (RR 1.27; 95% CI 1.21- 1.34; I2=0%). Overall risk of bias assessment was of low concern.
CONCLUSIONS: LGA did not differ between patients screened by one-step method and those by two-step method. However, patients randomized to one-step method had higher rates of neonatal hypoglycemia and NICU admission as well as maternal GDM diagnosis than the two-step method.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
American journal of obstetrics & gynecology MFM - (2024) vom: 11. März, Seite 101346 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Gomes, Cintia [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Gestational Diabetes |
|---|
| Anmerkungen: |
Date Revised 13.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.ajogmf.2024.101346 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369691954 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369691954 | ||
| 003 | DE-627 | ||
| 005 | 20240315000235.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240315s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ajogmf.2024.101346 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1329.xml |
| 035 | |a (DE-627)NLM369691954 | ||
| 035 | |a (NLM)38479488 | ||
| 035 | |a (PII)S2589-9333(24)00072-7 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Gomes, Cintia |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a One-step vs. two-step gestational diabetes mellitus screening and pregnancy outcomes |b an updated systematic review and meta-analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 13.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024. Published by Elsevier Inc. | ||
| 520 | |a OBJECTIVE: We performed a systematic review and meta-analysis comparing maternal and neonatal outcomes of patients screened with one-step or two-step screening methods for GDM | ||
| 520 | |a DATA SOURCES: Pubmed, Scopus, Cochrane, ClinicalTrials.gov, and LILACS were searched from inception up to September 2022 | ||
| 520 | |a STUDY ELIGIBILITY CRITERIA: Only randomized controlled trials (RCTs) were included. Studies that had overlapping populations were excluded (PROSPERO CRD42022358903) | ||
| 520 | |a STUDY APPRAISAL AND SYNTHESIS METHODS: Risk ratios (RR) were computed with 95% confidence intervals (CI) by two authors. Unpublished data were requested. Large for gestational age (LGA) was the primary outcome | ||
| 520 | |a RESULTS: The search yielded 394 citations. Seven RCTs met inclusion criteria. A total of 54,650 participants were screened for GDM by either the one-step method (N=27,163) or the two-step method (N=27,487). For LGA, there were no significant differences found between groups (RR 0.99; 95% CI 0.93-1.05; I2=0%). Newborns of patients in one-step testing had higher rates of neonatal hypoglycemia (RR 1.24; 95% CI 1.14-1.34; I2 =0%) and NICU admissions (RR 1.13; 95% CI 1.04-1.21; I2=0%). Patients in the one-step group were more likely to be diagnosed with GDM (RR 1.73; 95% CI 1.44-2.09; I2=80%). In addition, among trials that tested all patients prior to and excluded patients with pregestational diabetes, newborns were more likely to have macrosomia (RR 1.27; 95% CI 1.21- 1.34; I2=0%). Overall risk of bias assessment was of low concern | ||
| 520 | |a CONCLUSIONS: LGA did not differ between patients screened by one-step method and those by two-step method. However, patients randomized to one-step method had higher rates of neonatal hypoglycemia and NICU admission as well as maternal GDM diagnosis than the two-step method | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Gestational Diabetes | |
| 650 | 4 | |a Hypoglycemia | |
| 650 | 4 | |a Infant, Newborn | |
| 650 | 4 | |a Intensive Care Units, Neonatal | |
| 650 | 4 | |a Pregnancy Outcome | |
| 650 | 4 | |a Screening | |
| 700 | 1 | |a Futterman, Itamar D |e verfasserin |4 aut | |
| 700 | 1 | |a Sher, Ms Olivia |e verfasserin |4 aut | |
| 700 | 1 | |a Gluck, Ms Bracha |e verfasserin |4 aut | |
| 700 | 1 | |a Hillier, Teresa A |e verfasserin |4 aut | |
| 700 | 1 | |a Tehrani, Fahimeh Ramezani |e verfasserin |4 aut | |
| 700 | 1 | |a Chaarani, Mr Nadim |e verfasserin |4 aut | |
| 700 | 1 | |a Fisher, Nelli |e verfasserin |4 aut | |
| 700 | 1 | |a Berghella, Vincenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Jr, Rodney A McLaren |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of obstetrics & gynecology MFM |d 2019 |g (2024) vom: 11. März, Seite 101346 |w (DE-627)NLM297893440 |x 2589-9333 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:11 |g month:03 |g pages:101346 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ajogmf.2024.101346 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 11 |c 03 |h 101346 | ||