(993) Is Time Between Screening and Diagnosis of Gestational Diabetes Associated with Adverse Outcomes?

Objective: To determine whether the interval between gestational diabetes (GDM) screening glucose challenge test (GCT) and diagnostic glucose tolerance test (GTT) is associated with adverse perinatal outcomes

Study Design: A retrospective cohort study of singleton, non-anomalous pregnancies at one institution from 2019-2022 and diagnosed with GDM via the 2-step test. The primary outcome was a composite of perinatal morbidity: macrosomia, shoulder dystocia, hypertensive disorders of pregnancy, cesarean delivery for presumed macrosomia, neonatal intensive care unit (NICU) admission, among other adverse neonatal outcomes. The comparison groups included patients with an interval between GCT and GTT of less than 10 days or greater than or equal to 10 days. Bivariate analyses, univariable and multivariable regressions were performed

Results: Of 389 patients included, 258 (66.3%) had an interval of less than 10 days between GCT and GTT and 131 (33.7%) had an interval of greater than or equal to 10 days. Patients in the ³10 days group were more likely to be obese at time of GCT (30 vs 43.7%, p=0.009) and more likely to be of Black race (9.4 vs 19.2%, p=0.001) and have public insurance (16.3 vs 35.1%, p< 0.0001) (Table 1). There was a trend toward increased need for medication initiation in the ³10 day group (32.9 vs 42%, p=0.08) and a significantly later gestational age at initiation of medication (31.0 vs 32.9 weeks, p=0.003) (Table 2). In the univariate and multivariate analyses there was no significant differences in the composite outcome between the groups (< 10 vs ³10 days: aOR 1.03, 95% CI 0.64-1.67, p=0.9)

Conclusion: While patients who had GTT ³10 days after GCT were more likely to be Black, obese at time of GCT, have public insurance and initiated antihyperglycemic medication on average 2 weeks later than patients who had GTT within 10 days of GCT, no difference was seen in odds of adverse perinatal outcomes.