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Poster session II Clinical obstetrics, diabetes, labor, medical-surgical-disease, physiology/endocrinology, prematurity: Abstracts 237 - 386| Volume 208, ISSUE 1, SUPPLEMENT , S124-S125, January 01, 2013

273: Gestational diabetes screening: do neonatal outcomes differ based on one-step or two-step methods in a high risk population?

      Objective

      Our inner city obstetrical clinic changed their routine gestational diabetes screen from the 2 step 1 hour (1H) 50 g glucose screen to the one step 2 hour (2H) 75 g screen in July 2011. We sought to determine the effect of this change on neonatal outcomes.

      Study Design

      A retrospective chart review was performed for the nine months preceding the change in screening method through the first six months of the 2H one-step screen. Delivery date and results of diabetic screen were collected. We also collected infant outcomes including rates of NICU admission, small for gestation age (SGA), large for gestational age (LGA), hypoglycemia, hyperbilirubinemia, respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), culture proven sepsis, and necrotizing enterocolitis (NEC).

      Results

      There were 837 patients who delivered during the study period. Of these patients, 501 delivered during the 1H testing period and 336 delivered during the 2H testing period. During the 2H testing period there was an increase in the diagnosis of gestational diabetes from 7% to 11.7%. Rates of NICU admission, SGA, LGA, hypoglycemia, hyperbilirubinemia, RDS, IVH, culture proven sepsis, and NEC were similar between the two groups (see figure). The rate of hypoglycemia was 35.3% during the 1H testing period and 19.2% during the 2H testing period. This was not statistically significant.

      Conclusion

      Screening for gestation diabetes using the 2 step process does not result in a change in neonatal outcomes despite a high risk population. There was a trend towards decreased rates of hypoglycemia but this was not statistically significant.
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