Background:
With gestational diabetes mellitus (GDM) incidence increasing in Australia, current research is focused on validating diagnostic criteria and frameworks for management. Distinct from many other Australian centres, the Launceston General Hospital has offered universal early GDM screening before 20 weeks’ gestation since 2014: women with high risk factors undergo an oral glucose tolerance test (OGTT), women with low risk factors have a fasting glucose. Unless already diagnosed, women undergo an OGTT at 24–28 weeks’ gestation. This screening pathway has renewed relevance following the TOBOGM study which generated important data regarding the benefits/risks of diagnosing and treating early GDM.
Aim:
To investigate how gestational age and maternal glucose levels at GDM diagnosis influence maternal and neonatal outcomes.
Methods:
A retrospective cohort analysis will assess women diagnosed with GDM in 2014-2024 (n>1500), grouped by screening pathway: early screening of high-risk women (OGTT) and low-risk women (fasting glucose), or standard OGTT at 24-28 weeks. Outcomes will include rates of large- or small-for-gestational-age infants, other adverse neonatal outcomes, birth mode and the role of ultrasound-guided management. Outcomes with low positive OGTT (fasting 5.1-5.2, 1hr 10.0-10.5, 2hr 8.5-8.9 mmol/L) and high positive OGTT (fasting >/=5.3, 1hr >/=10.6, 2hr>/=9.0 mmol/L) will be compared. Expected completion 2026.
Expected Impact:
This study will complement the TOBOGM study and help identify the maternal and neonatal benefits or harms of universal early GDM screening. Findings will inform national diagnostic criteria discussions and optimise our delivery of antenatal care to Northern Tasmanian women.
Supported by the Clifford Craig Research Foundation