{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:53:16Z","timestamp":1781722396794,"version":"3.54.5"},"reference-count":41,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["TLS-185093"],"award-info":[{"award-number":["TLS-185093"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canadian Federal Government"},{"DOI":"10.13039\/501100000245","name":"Michael Smith Foundation for Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate changes in gestational diabetes mellitus (GDM) treatment and newborn birth weight after a 2010 change in GDM screening recommendations from a two-step (50-g glucose challenge test + 3-h, 100-g oral glucose tolerance test [OGTT] with Carpenter-Coustan criteria) to a mix of one-step and two-step (2-h, 75-g OGTT with International Association for Diabetes in Pregnancy Study Group criteria).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>We estimated effects of the screening change on the incidence of lifestyle or medication treatment, infant birth weight &amp;gt;90th percentile or &amp;lt;10th percentile for gestational age (large and small for gestational age), and endocrinologist visits using interrupted time series analysis in all 463,881 individuals with singleton pregnancies (&amp;gt;28 gestational weeks) from British Columbia, Canada, between 2004 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>After the screening change, lifestyle-treated GDM increased immediately (level change 1.85 [95% CI 1.19\u20132.51]), corresponding to a 1.85% increase in incidence. Medication-treated GDM increased gradually (trend change 0.23 [95% CI 0.09\u20130.37] per year), but there was no change in medication-treated GDM using a shorter (3-year) postpolicy period (level change \u22120.31 [95% CI \u22120.9 to 0.29]; trend change 0.03 [95% CI \u22120.36 to 0.43]). We detected no change in infant birth weight outcomes and endocrinology visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Changing the screening approach substantially increased diagnoses of lifestyle-treated GDM but did not impact medication-treated GDM or infant birth weight.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-0480","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T12:50:30Z","timestamp":1749041430000},"page":"1410-1417","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Effects of a Province-Wide Change in Gestational Diabetes Mellitus Screening Policy on Treatment and Newborn Birth Weight"],"prefix":"10.2337","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3453-9800","authenticated-orcid":false,"given":"Elizabeth","family":"Nethery","sequence":"first","affiliation":[{"name":"Faculty of Pharmaceutical Sciences, The University of British Columbia 1 , Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Hutcheon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of British Columbia 2 , Vancouver, British Columbia, Canada"},{"name":"British Columbia Children\u2019s Hospital Research Institute 3 , Vancouver, British Columbia, Canada"},{"name":"School of Population and Public Health, Faculty of Medicine, The University of British Columbia 4 , Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, The University of British Columbia 5 , Vancouver, British Columbia, Canada"},{"name":"Division of Endocrinology, Royal Columbian Hospital, Fraser Health Authority 6 , New Westminster, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A.","family":"Janssen","sequence":"additional","affiliation":[{"name":"British Columbia Children\u2019s Hospital Research Institute 3 , Vancouver, British Columbia, Canada"},{"name":"School of Population and Public Health, Faculty of Medicine, The University of British Columbia 4 , Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Schummers","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences, The University of British Columbia 1 , Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"2026061714330228500_B1","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1001\/jama.2021.10404","article-title":"Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force","volume":"326","author":"Pillay","year":"2021","journal-title":"JAMA"},{"key":"2026061714330228500_B2","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1056\/NEJMoa2026028","article-title":"A pragmatic, randomized clinical trial of gestational diabetes screening","volume":"384","author":"Hillier","year":"2021","journal-title":"N Engl J Med"},{"key":"2026061714330228500_B3","doi-asserted-by":"crossref","first-page":"101346","DOI":"10.1016\/j.ajogmf.2024.101346","article-title":"One-step vs 2-step gestational diabetes mellitus screening and pregnancy outcomes: an updated systematic review and meta-analysis","volume":"6","author":"Gomes","year":"2024","journal-title":"Am J Obstet Gynecol MFM"},{"key":"2026061714330228500_B4","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1056\/NEJMoa2204091","article-title":"Lower versus higher glycemic criteria for diagnosis of gestational diabetes","volume":"387","author":"Crowther","year":"2022","journal-title":"N Engl J Med"},{"key":"2026061714330228500_B5","doi-asserted-by":"crossref","first-page":"e1004420","DOI":"10.1371\/journal.pmed.1004420","article-title":"Changing diagnostic criteria for gestational diabetes (CDC4G) in Sweden: a stepped wedge cluster randomised trial","volume":"21","author":"de Brun","year":"2024","journal-title":"PLoS Med"},{"key":"2026061714330228500_B6","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1097\/AOG.0000000000004943","article-title":"One-step compared with two-step gestational diabetes screening and pregnancy outcomes: a systematic review and meta-analysis","volume":"140","author":"Brady","year":"2022","journal-title":"Obstet Gynecol"},{"key":"2026061714330228500_B7","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/AOG.0000000000004431","article-title":"Perinatal outcomes of two screening strategies for gestational diabetes mellitus: a randomized controlled trial","volume":"138","author":"Davis","year":"2021","journal-title":"Obstet Gynecol"},{"key":"2026061714330228500_B8","doi-asserted-by":"crossref","first-page":"2442","DOI":"10.2337\/dc14-0179","article-title":"Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St. Carlos Gestational Diabetes Study","volume":"37","author":"Duran","year":"2014","journal-title":"Diabetes Care"},{"key":"2026061714330228500_B9","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1080\/03054985.2012.731208","article-title":"Single group, pre- and post-test research designs: some methodological concerns","volume":"38","author":"Marsden","year":"2012","journal-title":"Oxf Rev Educ"},{"key":"2026061714330228500_B10","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jclinepi.2017.03.012","article-title":"Quasi-experimental study designs series\u2014paper 4: uses and value","volume":"89","author":"B\u00e4rnighausen","year":"2017","journal-title":"J Clin Epidemiol"},{"key":"2026061714330228500_B11","unstructured":"Reeves\n              BC\n            , DeeksJJ, HigginsJPT, SheaB, TugwellP, WellsGA; Cochrane Non-Randomized Studies of Interventions Methods Group. Chapter 24: including non-randomized studies on intervention effects. 2024. Accessed 25 March 2025. Available from https:\/\/training.cochrane.org\/handbook\/current\/chapter-24"},{"key":"2026061714330228500_B12","first-page":"348","article-title":"Interrupted time series regression for the evaluation of public health interventions: a tutorial","volume":"46","author":"Bernal","year":"2017","journal-title":"Int J Epidemiol"},{"key":"2026061714330228500_B13","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.jogc.2023.01.002","article-title":"Trends in gestational diabetes screening practices in British Columbia from 2005-2019","volume":"45","author":"Nethery","year":"2023","journal-title":"J Obstet Gynaecol Can"},{"key":"2026061714330228500_B14","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s12884-015-0563-7","article-title":"Validating the British Columbia Perinatal Data Registry: a chart re-abstraction study","volume":"15","author":"Frosst","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026061714330228500_B15","unstructured":"Perinatal Services BC (2011)\n          . British Columbia Perinatal Data Registry. Population Data BC. Data Extract. PSBC (2012). https:\/\/www.perinatalservicesbc.ca\/health-professionals\/data-surveillance\/perinatal-data-registry"},{"key":"2026061714330228500_B16","first-page":"S168","article-title":"Canadian Diabetes Association 2008 clinical practice guidelines for the prevention and management of diabetes in Canada","volume":"32","author":"Canadian Diabetes Association Clinical Practice Guidelines Expert Committee.","year":"2008","journal-title":"Can J Diabetes"},{"key":"2026061714330228500_B17","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jcjd.2014.09.007","article-title":"Evaluation of the International Association of the Diabetes in Pregnancy Study Group new criteria: gestational diabetes project","volume":"39","author":"Kong","year":"2015","journal-title":"Can J Diabetes"},{"key":"2026061714330228500_B18","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/aogs.15098","article-title":"Perinatal outcomes following nonadherence to guideline-based screening for gestational diabetes: a population-based cohort study","volume":"104","author":"Nethery","year":"2025","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2026061714330228500_B19","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/EDE.0000000000001569","article-title":"Validation of insurance billing codes for monitoring antenatal screening","volume":"34","author":"Nethery","year":"2023","journal-title":"Epidemiology"},{"key":"2026061714330228500_B20","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00125-018-4758-0","article-title":"Association between maternal diabetes, being large for gestational age and breast-feeding on being overweight or obese in childhood","volume":"62","author":"Kaul","year":"2019","journal-title":"Diabetologia"},{"key":"2026061714330228500_B21","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1007\/s00125-021-05381-y","article-title":"Size for gestational age affects the risk for type 1 diabetes in children and adolescents: a Swedish national case\u2013control study","volume":"64","author":"Lindell","year":"2021","journal-title":"Diabetologia"},{"key":"2026061714330228500_B22","doi-asserted-by":"crossref","first-page":"124","DOI":"10.7570\/jomes20130","article-title":"Large for gestational age and obesity-related comorbidities","volume":"30","author":"Hong","year":"2021","journal-title":"J Obes Metab Syndr"},{"key":"2026061714330228500_B23","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and Adverse Pregnancy Outcomes","volume":"358","author":"The HAPO Study Cooperative Research Group","year":"2008","journal-title":"N Engl J Med"},{"key":"2026061714330228500_B24","first-page":"28","article-title":"New birth weight and gestational age charts for the British Columbia population","volume":"48","author":"Kierans","year":"2006","journal-title":"BC Med J"},{"key":"2026061714330228500_B25","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1097\/AOG.0000000000002501","article-title":"ACOG practice bulletin no. 190: gestational diabetes mellitus","volume":"131","year":"2018","journal-title":"Obstet Gynecol"},{"key":"2026061714330228500_B26","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1080\/14767058.2016.1257603","article-title":"Current trends in the diagnosis and management of gestational diabetes mellitus in the United States","volume":"30","author":"Bimson","year":"2017","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2026061714330228500_B27","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jclinepi.2017.02.017","article-title":"Quasi-experimental study designs series\u2014paper 7: assessing the assumptions","volume":"89","author":"B\u00e4rnighausen","year":"2017","journal-title":"J Clin Epidemiol"},{"key":"2026061714330228500_B28","unstructured":"Lindon\n              N\n            , Hartmann-BoyceJ, BeroL, . Determining the quantitative study designs to be included in a systematic review of interventions. 2024. Accessed 25 March 2025. Available from https:\/\/methods.cochrane.org\/methods-cochrane\/determining-quantitative-study-designs-be-included-systematic-review-interventions"},{"key":"2026061714330228500_B29","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12874-021-01306-w","article-title":"Comparison of six statistical methods for interrupted time series studies: empirical evaluation of 190 published series","volume":"21","author":"Turner","year":"2021","journal-title":"BMC Med Res Methodol"},{"key":"2026061714330228500_B30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.jclinepi.2008.08.007","article-title":"Methods for estimating confidence intervals in interrupted time series analyses of health interventions","volume":"62","author":"Zhang","year":"2009","journal-title":"J Clin Epidemiol"},{"key":"2026061714330228500_B31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/ijerph18041454","article-title":"Trends in national Canadian guideline recommendations for the screening and diagnosis of gestational diabetes mellitus over the years: a scoping review","volume":"18","author":"Mussa","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026061714330228500_B32","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.jogc.2016.04.002","article-title":"Diabetes in pregnancy","volume":"38","author":"Berger","year":"2016","journal-title":"J Obstet Gynaecol Can"},{"key":"2026061714330228500_B33","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/s11606-016-3841-9","article-title":"False dichotomies and health policy research designs: randomized trials are not always the answer","volume":"32","author":"Soumerai","year":"2017","journal-title":"J Gen Intern Med"},{"key":"2026061714330228500_B34","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1056\/NEJMoa1905593","article-title":"Lower versus traditional treatment threshold for neonatal hypoglycemia","volume":"382","author":"van Kempen","year":"2020","journal-title":"N Engl J Med"},{"key":"2026061714330228500_B35","doi-asserted-by":"crossref","first-page":"1179102","DOI":"10.3389\/fendo.2023.1179102","article-title":"Neonatal hypoglycemia: lack of evidence for a safe management","volume":"14","author":"Roeper","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026061714330228500_B36","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1001\/jamapediatrics.2023.3957","article-title":"Infants eligible for neonatal hypoglycemia screening: a systematic review","volume":"177","author":"O'Brien","year":"2023","journal-title":"JAMA Pediatr"},{"key":"2026061714330228500_B37","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2337\/dc12-0741","article-title":"The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth","volume":"36","author":"Black","year":"2013","journal-title":"Diabetes Care"},{"key":"2026061714330228500_B38","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/AOG.0000000000001132","article-title":"Gestational diabetes screening: the International Association of the Diabetes and Pregnancy Study Groups compared with Carpenter-Coustan screening","volume":"127","author":"Feldman","year":"2016","journal-title":"Obstet Gynecol"},{"key":"2026061714330228500_B39","first-page":"33","article-title":"Beyond one size fits all: probing patient choices in gestaional diabetes management, from screening to postpartum","volume":"11","author":"Mobin","year":"2025","journal-title":"Chronic Dis Transl Med"},{"key":"2026061714330228500_B40","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s12884-020-2745-1","article-title":"Women\u2019s experiences of a diagnosis of gestational diabetes mellitus: a systematic review","volume":"20","author":"Craig","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026061714330228500_B41","doi-asserted-by":"crossref","first-page":"781384","DOI":"10.3389\/fendo.2021.781384","article-title":"Preference of women for gestational diabetes screening method according to tolerance of tests and population characteristics","volume":"12","author":"Raets","year":"2021","journal-title":"Front Endocrinol (Lausanne)"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/48\/8\/1410\/819981\/dc250480.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/48\/8\/1410\/819981\/dc250480.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:33:14Z","timestamp":1781721194000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/48\/8\/1410\/160551\/Effects-of-a-Province-Wide-Change-in-Gestational"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,4]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,6,4]]},"published-print":{"date-parts":[[2025,8,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc25-0480","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,4]]}}}