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Universal vs. risk factor-based screening for gestational diabetes mellitus: detection rates, gestation at diagnosis and outcome
Published in:
Diabet Med, Vol: 17, Page: 26-32
Publication Date:
January 2000
Aims & Objectives:
The aim of this study was to assess a risk factor-based screening programme with a universally based one - for gestational diabetes mellitus
Abstract:
AIMS: Gestational diabetes mellitus (GDM) is associated with adverse maternal and fetal outcome. Screening for GDM is therefore recommended but the best screening method remains controversial. This prospective, randomized study compared a risk factor-based screening programme with a universally based one. METHODS: Subjects were randomized at booking to one of two groups: the risk factor group had a 3-h 100-g oral glucose tolerance test (OGTT) at 32 weeks if any risk factor for GDM was present; the universal group had a 50-g glucose challenge test performed and if their plasma glucose at 1 h was > or = 7.8 mmol/l, a formal 3-h 100-g OGTT was then performed. RESULTS: Universal screening detected a prevalence of GDM of 2.7%, significantly more than the 1.45% detected in the risk factor screened group (P<0.03). Universal screening facilitated earlier diagnosis than risk factor screening - mean gestation 30 +/- 2.6 weeks vs. 33 +/- 3.7 weeks (P<0.05). A higher rate of spontaneous vaginal delivery at term, and lower rates of macrosomia, Caesarean section, prematurity, pre-eclampsia and admission to neonatal intensive care unit were observed in the universally screened, early diagnosis group. CONCLUSIONS: Universal screening for GDM is superior to risk factor based screening-detecting more cases, facilitating early diagnosis and is associated with improved pregnancy outcome.
Authors:
Study Type:
Study Papers » A randomized controlled trial » Descriptive Studies - Studies with a health technology dimension
Categories:
gestational diabetes mellitus
International Classification:
Evaluation of the effectiveness of two gestational diabetes mellitus screening programmes
Keywords:
- Blood Glucose/metabolism
- Cesarean Section/statistics & numerical data
- Delivery, Obstetric
- Diabetes, Gestational/ diagnosis/epidemiology
- Female
- Fetal Macrosomia/epidemiology
- Glucose Tolerance Test
- Humans
- Hyperbilirubinemia/epidemiology
- Hypoglycemia/epidemiology
- Infant, Newborn
- Infant, Premature
- Intensive Care Units, Neonatal/statistics & numerical data
- Ireland/epidemiology
- Mass Screening/ methods
- Pre-Eclampsia/epidemiology
- Pregnancy
- Pregnancy Outcome
- Prevalence
- Prospective Studies
- Risk Factors
Geography:
Republic of Ireland (Dublin)