Journal Article

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

Jatavan, Phudit, Tongsong, Theera, Phoblap, Natthaphon

2025

Overview

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. 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.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Adult / Birth weight / Cesarean section / Developing countries / Diabetes / Diabetes mellitus / Diabetes, Gestational - diagnosis / Diabetes, Gestational - epidemiology / Female / Follow-Up Studies / Gestational age / Gestational diabetes / Gestational diabetes mellitus / Glucose / Glucose tolerance / Glucose tolerance test / Glucose Tolerance Test - methods / Humans / Hypoglycemia / LDCs / Mass Screening - methods / Methods / Neonates / Original / Pregnancy / Pregnancy complications / Pregnancy Outcome / Prenatal care / Prevalence / Prognosis / Southeast Asian People / Thailand - epidemiology / Universal screening