Evidence-based medicine experts have called for urgent review of gestational diabetes diagnosis criteria after a randomised trial found one-step screening holds no health benefits for mothers or babies.

In fact, the findings validate concerns that up to 25% of pregnant women and their infants may be at greater risk of harm with the use of a lower fasting glucose cut-off of 5.1mmol/L, say Brisbane GP and researcher Professor Jenny Doust, from the University of Queensland, and colleagues.

Although the Australasian Diabetes in Pregnancy Society and RANZCOG have endorsed the one-step approach, involving a two-hour fasting oral glucose tolerance test (OGTT), the RACGP has not, preferring the traditional two-step approach of a glucose challenge test followed by OGTT with a higher cut-off for diagnosis of 5.5mmol/L.

The US trial involving nearly 24,000 women should prompt change, said Professor Doust, GP Professor Paul Glasziou from Bond University and leading endocrinologist Associate Professor Michael d’Emden from Royal Brisbane and Women’s Hospital in a commentary in the Medical Journal of Australia.