Beschreibung:
<jats:sec><jats:title>Background</jats:title><jats:p>Recent guidelines suggest screening high‐risk women in early pregnancy for gestational diabetes (<jats:styled-content style="fixed-case">GDM</jats:styled-content>); however, there is little evidence to support this.</jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p>To compare pregnancy outcomes associated with diabetes for women with risk factors for <jats:styled-content style="fixed-case">GDM</jats:styled-content> according to gestation of diagnosis. Early <jats:styled-content style="fixed-case">GDM</jats:styled-content> was defined as a positive test before 20 weeks gestation, late <jats:styled-content style="fixed-case">GDM</jats:styled-content> as a positive test at 20 or more weeks and no <jats:styled-content style="fixed-case">GDM</jats:styled-content> when both tests were negative.</jats:p></jats:sec><jats:sec><jats:title>Materials and methods</jats:title><jats:p>Retrospective analysis in an Australian tertiary hospital of women who underwent a glucose tolerance test in pregnancy prior to 20 weeks gestation, and a repeat test after 20 weeks gestation if the initial test was negative. Results were adjusted for maternal demographics.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Women with early <jats:styled-content style="fixed-case">GDM</jats:styled-content> (<jats:italic>n </jats:italic>=<jats:italic> </jats:italic>170) were no more likely to experience the obstetric composite outcome than women with late <jats:styled-content style="fixed-case">GDM</jats:styled-content> (<jats:italic>n </jats:italic>=<jats:italic> </jats:italic>171) or no <jats:styled-content style="fixed-case">GDM</jats:styled-content> (<jats:italic>n </jats:italic>=<jats:italic> </jats:italic>547) (early odds ratio (<jats:styled-content style="fixed-case">OR)</jats:styled-content> 1.16, 95%<jats:styled-content style="fixed-case">CI</jats:styled-content> 0.79–1.71; late <jats:styled-content style="fixed-case">OR</jats:styled-content> 0.78, 95%<jats:styled-content style="fixed-case">CI</jats:styled-content> 0.53–1.12). Infants of women with early <jats:styled-content style="fixed-case">GDM</jats:styled-content>, but not late <jats:styled-content style="fixed-case">GDM</jats:styled-content>, were more likely (early <jats:styled-content style="fixed-case">OR</jats:styled-content> 1.8, 95%<jats:styled-content style="fixed-case">CI</jats:styled-content> 1.15–2.92; late <jats:styled-content style="fixed-case">OR</jats:styled-content> 1.4, 95%<jats:styled-content style="fixed-case">CI</jats:styled-content> 0.90–2.23) to have the neonatal composite outcome than infants of women without <jats:styled-content style="fixed-case">GDM</jats:styled-content>, predominantly due to an increase in neonatal hypoglycaemia.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>This result may be due to careful management of <jats:styled-content style="fixed-case">GDM</jats:styled-content>, or because, after adjustment for maternal demographics, the early diagnosis of <jats:styled-content style="fixed-case">GDM</jats:styled-content> does not substantially increase rates of adverse outcomes compared to <jats:styled-content style="fixed-case">GDM</jats:styled-content> diagnosed in later pregnancy or no <jats:styled-content style="fixed-case">GDM</jats:styled-content> in women with risk factors for <jats:styled-content style="fixed-case">GDM</jats:styled-content>.</jats:p></jats:sec>