How Effective the Structured Training in the Decision of Screening of Gestational Diabetes? Randomised Controlled Trial

This is a randomised controlled intervention study. This was conducted at Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, in İstanbul, Türkiye, between January-July 2019. Ethical permission was obtained from the Hospital's Ethics Committee (Approval date/number: 07.11.2018/141). The formal study permission was obtained from the İstanbul Province Health Directorate because the hospital was an governmental hospital. All eligible participants were informed and they were invited to the study and the accepted participants signed their consents.

Antenatal follow-up in Türkiye is conducted in accordance with the Ministry of Health's Prenatal Care Management Guide. This guidance recommends 50 g glucose challenge test (GCT) between 24-28 weeks for pregnant women who are not at high risk.

The target group of the study consisted of pregnant women who applied to the outpatient clinics of the hospital in İstanbul. Pregnant women over the age of 18, between the 24-28th weeks of pregnancy, who could speak Turkish, were literate were included in the study. Pregnant women diagnosed with diabetes before pregnancy, in the first trimester or third trimester, with speech and hearing impairments, and those who were not literate in Turkish were excluded from the study.

The sample size was calculated with the Open-Epi program. Hospital electronic data for 2017 was reviewed and it was determined that only 40% of pregnant women who were recommended 50 g GCT had the test. The sample calculation was made with the expectation that this rate would increase to 60% with the training planned in the study. The number of pregnant women to be included in the study was calculated as 98 for each group, 196 in total. The probability of lost to follow-up was calculated as 40% and the sample size was increased to 280(140+140).

Patient recruitment was conducted between May and June 2019. Two hundred and five volunteer pregnant women who met the inclusion criteria, had not yet been diagnosed with diabetes mellitus according to national and international guidelines, and were recommended for GCT were invited to participate in the study. They were randomly assigned to two groups: control (n=101) and intervention (n=104). Participants were randomly assigned to either the intervention group or the control group in a 1:1 using a simple coin toss method. Outpatient examination time was 15 minutes. Pregnant women were given standard information about GCT during this time. The GCT was recommended verbally, directly to control group. Pregnant women assigned to the intervention group were invited to trainings.