Lower GDM diagnostic thresholds raise diagnoses without improving short-term outcomes

A systematic review and meta-analysis of 17 studies (nine RCTs, one cohort, 81,528 women) compared lower versus higher glycemic diagnostic criteria for gestational diabetes. The review found lower thresholds doubled GDM diagnosis and pharmacotherapy use and increased neonatal hypoglycemia and maternal-neonatal separation, with little effect on other short-term outcomes; one RCT's five-year follow-up suggested possible reductions in maternal hypertension and child neurodevelopmental impairment but increased subsequent GDM, and cost data were inconsistent with no long-term economic data available.

Most relevant for: Clinicians involved in screening and diagnostic threshold decisions for gestational diabetes during pregnancy.

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