Last updated September 9, 2026
Key finding
Adjusted risk ratio (aRR) of 0.97 (95% CI 0.91 to 1.02, p = 0.26)
This study evaluated the impact of switching to WHO-2013 criteria for diagnosing gestational diabetes mellitus (GDM) and found no significant change in large for gestational age (LGA) outcomes.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Long-Term (1–5 y)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the impact of switching to WHO-2013 criteria for diagnosing gestational diabetes mellitus (GDM) and found no significant change in large for gestational age (LGA) outcomes.
Understanding the implications of diagnostic criteria for gestational diabetes is crucial for maternal and neonatal health. This study's findings suggest that the transition to WHO-2013 criteria does not increase the risk of having larger babies, which can lead to complications during delivery. Clinicians can feel reassured that adopting these criteria will not negatively impact birth outcomes.
The study's effectiveness was unclear due to non-significant findings. Limited generalizability as the population may not represent all demographics. Potential unmeasured confounders affecting outcomes. The sample size may limit the power to detect smaller effects.
Published in
Publication details and source links for this paper.
Maryam DB, Anders M, Scott M, et al. Switching Diagnostic Criteria for Gestational Diabetes Mellitus: A Stepped Wedge Cluster Randomized Trial. PLOS Medicine. 2024;21(7):e1004420. doi:10.1371/journal.pmed.1004420
No significant change in LGA rates (11.5% vs 11.4%) after switching criteria.
Adjusted risk ratio for LGA was 0.97 (95% CI 0.91 to 1.02, p = 0.26).
In a discordant subgroup, LGA prevalence decreased from 28.8% to 22.5%, aRR 0.87 (p = 0.076).
No serious maternal or neonatal complications were reported.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Switch to WHO-2013 GDM criteria and Adjusted risk ratio for LGA, Bacteroidaceae levels in standard diet group, Neonatal complications, and 1 more.
This study contributes evidence to
Primary intervention
Switch to WHO-2013 GDM criteria
Primary outcomes
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
0
Related topics
4
Evidence pairs
0
Related studies
Core evidence
The primary outcomes reported in this study.
Switch to WHO-2013 GDM criteria → Adjusted risk ratio for LGA
Switch to WHO-2013 GDM criteria → Adjusted risk ratio for LGA
Switch to WHO-2013 GDM criteria → Bacteroidaceae levels in standard diet group
Switch to WHO-2013 GDM criteria → Bacteroidaceae levels in standard diet group
Switch to WHO-2013 GDM criteria → Neonatal complications
Switch to WHO-2013 GDM criteria → Neonatal complications
Switch to WHO-2013 GDM criteria → Proportion of large-for-gestational-age newborns
Switch to WHO-2013 GDM criteria → Proportion of large-for-gestational-age newborns
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Switch to WHO-2013 GDM criteria and Adjusted risk ratio for LGA, Switch to WHO-2013 GDM criteria and Bacteroidaceae levels in standard diet group.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies measuring Adjusted risk ratio for LGA
Measures Adjusted risk ratio for LGA as a key outcome.
All studies measuring Bacteroidaceae levels in standard diet group
Measures Bacteroidaceae levels in standard diet group as a key outcome.
All studies on Switch to WHO-2013 GDM criteria
Contributes to Switch to WHO-2013 GDM criteria evidence base.
Latest published studies
Published within the last 2 years.
Jump to pre-filtered views in Evidence Explorer.
1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Current evidence does not show a clear reduction in adjusted risk ratio for lga with Switch to WHO-2013 GDM criteria.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Adjusted risk ratio for LGA
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Switch to WHO-2013 GDM criteria for bacteroidaceae levels in standard diet group.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Bacteroidaceae levels in standard diet group
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Switch to WHO-2013 GDM criteria for neonatal complications.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Neonatal complications
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Switch to WHO-2013 GDM criteria for proportion of large-for-gestational-age newborns.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Proportion of large-for-gestational-age newborns
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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