Screening gestational diabetes with a single fasting glucose versus an oral glucose tolerance test yields similar perinatal outcomes in a multiethnic population.

AIMS: To evaluate perinatal outcomes of women with gestational diabetes (GDM) excluded by a fasting plasma glucose (FPG) <4.7 mmol/L using a simplified screening method versus women with a fasting glucose <4.7 mmol/L with or without GDM by oral glucose tolerance test (OGTT). METHODS: A retrospective cohort study included singleton births from 20 weeks' gestation. Women who underwent simplified screening (delivered between 1st January 2021-31st December 2021) were included if FPG < 4.7 mmol/L (GDM excluded without an OGTT; screen negative). Women who underwent a 2-hour 75 g OGTT (delivered between 1st January 2020-31st July 2021) were included if the fasting glucose was <4.7 mmol/L with either normal glucose tolerance (NGT) or GDM. Perinatal outcomes were compared between groups, stratified by maternal birth region. RESULTS: 3188 women were screen negative, 4802 had NGT and 468 had GDM. The screen negative group had comparable perinatal outcomes to the NGT group. The GDM group, particularly women born in Central/South-East Asia, had higher rates of small-for-gestational-age infants than screen negative women. CONCLUSIONS: A FPG < 4.7 mmol/L may provide a pragmatic alternative to OGTT screening with comparable perinatal outcomes. Future research is required to further characterise GDM subtypes and determine whether simplified screening can support individualised risk stratification and management.