Screening for gestational diabetes mellitus in adolescent Hispanics

Objective: To determine the incidence of gestational diabetes mellitus in an adolescent Hispanic population and calculate the cost of screening.Methods: A retrospective chart review of deliveries to adolescent (<20 years old) Hispanic women from January 1991 through May 1996 was performed. The incidence of gestational diabetes mellitus (GDM) was determined and the cost of screening calculated.Results: Three hundred twenty-six adolescent Hispanic women were screened for GDM with a 1-hour 50-g oral glucose tolerance test at an average gestational age of 26 weeks (range 11-39 weeks), at a cost of $26 per test. Thirty (9.2%) had positive screens defined as a plasma glucose level of >/=140 mg%. Three-hour 100-g oral glucose tolerance tests were performed on those with positive screens, at a cost of $124 per test. Five women were diagnosed with GDM, an incidence of 1.5%. The cost to diagnose each case of GDM was $2,569.Conclusion: The incidence of GDM in this population is low, and therefore universal screening of Hispanic adolescents may be unwarranted and cost prohibitive. Large prospective trials evaluating maternal and neonatal outcomes would provide the best means to assess the value of screening.