Does Early Screening for Gestational Diabetes Improve Pregnancy Outcomes?

Universal screening for gestational diabetes (GD) is recommended between 24 and 28 weeks of pregnancy (JAMA 2021; 326:531). The American College of Obstetrics and Gynecology recommends considering earlier screening for women with body-mass index ≥25 kg/m² and at least one additional risk factor for GD (Obstet Gynecol 2018; 131:e49). However, whether earlier screening and treatment improves outcomes is unclear.

To examine this issue, researchers performed oral glucose tolerance tests (2-hour 75-g OGTT) in 3681 pregnant women before 20 weeks' gestation. The 802 women who met diagnostic criteria for GD were randomized to immediate treatment or to deferred (or no) treatment, pending results of repeat screening at 24 to 28 weeks. For two of the p…