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Obstetrics and Gynecology International
Volume 2018, Article ID 1521794, 5 pages
Research Article

Comparison of the Screening Tests for Gestational Diabetes Mellitus between “One-Step” and “Two-Step” Methods among Thai Pregnant Women

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Correspondence should be addressed to Theera Tongsong;

Received 16 June 2017; Accepted 26 December 2017; Published 8 February 2018

Academic Editor: Faustino R. Perez-Lopez

Copyright © 2018 Suchaya Luewan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To compare the prevalence and pregnancy outcomes of GDM between those screened by the “one-step” (75 gm GTT) and “two-step” (100 gm GTT) methods. Methods. A prospective study was conducted on singleton pregnancies at low or average risk of GDM. All were screened between 24 and 28 weeks, using the one-step or two-step method based on patients’ preference. The primary outcome was prevalence of GDM, and secondary outcomes included birthweight, gestational age, rates of preterm birth, small/large-for-gestational age, low Apgar scores, cesarean section, and pregnancy-induced hypertension. Results. A total of 648 women were screened: 278 in the one-step group and 370 in the two-step group. The prevalence of GDM was significantly higher in the one-step group; 32.0% versus 10.3%. Baseline characteristics and pregnancy outcomes in both groups were comparable. However, mean birthweight was significantly higher among pregnancies with GDM diagnosed by the two-step approach (3204 ± 555 versus 3009 ± 666 g; ). Likewise, the rate of large-for-date tended to be higher in the two-step group, but was not significant. Conclusion. The one-step approach is associated with very high prevalence of GDM among Thai population, without clear evidence of better outcomes. Thus, this approach may not be appropriate for screening in a busy antenatal care clinic like our setting or other centers in developing countries.