{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T16:15:02Z","timestamp":1758039302655,"version":"3.44.0"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2018\u201000470"],"award-info":[{"award-number":["2018\u201000470"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011077","name":"Sk\u00e5nes universitetssjukhus","doi-asserted-by":"publisher","award":["REGSKANE\u2010622891"],"award-info":[{"award-number":["REGSKANE\u2010622891"]}],"id":[{"id":"10.13039\/501100011077","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"abstract":"ABSTRACT<\/jats:title>Objective<\/jats:title>To estimate the effect on healthcare resource use after introducing the World Health Organization diagnostic criteria (WHO\u20102013) for gestational diabetes mellitus (GDM) compared to former criteria in Sweden (SWE\u2010GDM).<\/jats:p><\/jats:sec>Design<\/jats:title>A cost\u2010analysis alongside the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) randomised controlled trial.<\/jats:p><\/jats:sec>Setting<\/jats:title>Sweden, with risk\u2010factor based screening for GDM.<\/jats:p><\/jats:sec>Population<\/jats:title>47\u2009080 pregnant women and their infants.<\/jats:p><\/jats:sec>Methods<\/jats:title>A register\u2010based cost\u2010analysis from a healthcare perspective alongside a stepped\u2010wedge cluster RCT of switching from SWE\u2010GDM to WHO\u20102013 criteria in 2018. Analyses were made on the population level and repeated in the subgroup affected by the intervention, that is, those with plasma glucose values between SWE\u2010GDM and WHO\u20102013 criteria. Sensitivity analysis by bootstrapping was performed.<\/jats:p><\/jats:sec>Main Outcome Measures<\/jats:title>Estimated costs for obstetric surveillance (including GDM\u2010management), delivery and neonatal healthcare until 28\u2009days postpartum.<\/jats:p><\/jats:sec>Results<\/jats:title>On a population level, the WHO\u20102013 criteria were associated with increased costs of obstetric surveillance (adjusted mean [bootstrap confidence interval]) \u20ac94.0 [24.5\u2013169.1], delivery care \u20ac20.4 [\u221233.5 to 75.4] and neonatal care \u20ac331.0 [75.1\u2013589.0] per pregnancy, and in the affected subgroup \u20ac606.9 [377.7\u2013872.4], \u20ac348.5 [126.0\u2013542.0] and \u20ac129.3 [\u2212559.0 to 980.9] respectively.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Implementation of the WHO\u20102013 criteria in Sweden was associated with increased costs for obstetric surveillance and delivery on a population level, driven by the affected subgroup. The increased costs for neonatal care were associated with large uncertainty. A detailed understanding of the changes in resource use can guide decisions to mitigate cost increases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18364","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T03:25:49Z","timestamp":1757561149000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implications of Changing the Diagnostic Criteria for Gestational Diabetes Mellitus (CDC4G<\/scp>): A Healthcare Cost Analysis Alongside a Stepped Wedge Cluster Randomised Trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1017-2124","authenticated-orcid":false,"given":"Maryam","family":"de Brun","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine and Health \u00d6rebro University \u00d6rebro 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Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna\u2010Karin","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University, Akademiska Sjukhuset Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Strevens","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Sk\u00e5ne University Hospital, Department of Clinical Sciences Lund Lund University Lund Sweden"},{"name":"Department of Clinical Sciences Lund Lund University Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrik","family":"Ahlsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University, Akademiska Sjukhuset Uppsala 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