(1121) Pregnancy outcomes and early screening for gestational diabetes among high-risk patients based on ACOG’s criteria

Friday, February 10, 2023

3:30 PM – 5:00 PM

Objective: Currently there are no published randomized control trials on early screening for gestational diabetes (GDM) in high-risk patients based on the American College of Obstetricians and Gynecologists (ACOG) criteria. We aim to evaluate whether early screening for GDM in patients deemed high-risk based on ACOG criteria lead to improved pregnancy outcomes.

Study Design: This was a retrospective cohort study of patients who delivered between 2017 and 2018 and met ACOG criteria for early screening (BMI >24 kg/m² plus one other high-risk factor such as history of GDM) at a single center. Patients were divided into two groups: those who received early screening and those who did not receive early screening. Pregnancy outcomes including GDM, gestational hypertension (gHTN), preeclampsia (PEC), cesarean delivery (CD), preterm birth (PTB), birthweight, macrosomia, neonatal hypoglycemia, and NICU admission were compared between both groups using univariate and multivariate analyses.

Results: Of the 751 patients included, only 250 (33.3%) received early screening and 501 (66.7%) did not. Of the 250 patients who were screened early, 7 (2.8%) were diagnosed with early GDM. Patients who received early screening were more likely to be older, have a higher pre-gravid BMI, a history of GDM in prior pregnancies, and/or chronic hypertension (Table 1). After adjusting for these differences, patients who were screened early did not differ in gHTN, CD, PTB, macrosomia, neonatal hypoglycemia, and NICU admission compared to patients who were not screened early. However, those who screened early had a higher rate of PEC (aOR 2.19, 95% CI 1.32, 3.64) (Table 2).

Conclusion:
Early GDM screening in high-risk patients based on ACOG’s risk factors may not improve pregnancy outcomes. More evidence is needed to evaluate the utility of early screening on identifying pregnancy outcomes based on these risk factors.

Primary & Presenting Author(s)

Rachel Huang, BA (she/her/hers)
Medical Student
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, Pennsylvania, United States

Coauthor(s)
KB
Katherine C. Bodycot, BS
Medical Student
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, Pennsylvania, United States

HA
Huda B. Al-Kouatly, MD
Thomas Jefferson University
Philadelphia, Pennsylvania, United States

Rodney A. McLaren, Jr., MD
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, United States