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Published on: January 7, 2018
Risk factor screening for abnormal glucose tolerance in pregnancy.
K Shamsuddin1, Z A Mahdy, I Siti Rafiaah
1Department of Community Health, Medical Faculty, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. khadijah@mail.hukm.ukm.my
Summary
Traditional risk factor screening for gestational diabetes mellitus (GDM) is unreliable, missing many cases. Universal screening is more accurate and cost-effective for diagnosing GDM in pregnant women.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Gestational diabetes mellitus (GDM) affects a significant number of pregnancies.
- Accurate and cost-effective screening methods for GDM are crucial for maternal and fetal health.
- Traditional risk factor screening has limitations in identifying all GDM cases.
Purpose of the Study:
- To evaluate the prevalence of GDM.
- To assess the association of common risk factors with GDM.
- To compare the diagnostic validity and cost-effectiveness of universal GDM screening versus risk factor-based screening.
Main Methods:
- A cross-sectional survey of 768 pregnant women at or beyond 24 weeks' gestation.
- Risk factors were identified via questionnaire.
- GDM diagnosis was based on an abnormal oral glucose tolerance test (2-h post-prandial blood sugar ≥ 7.8 mmol/l).
Main Results:
- The prevalence of GDM was 24.9% (191 out of 768 women).
- Commonly identified risk factors included family history of diabetes, history of spontaneous abortion, and maternal age >35.
- Most risk factors showed no significant association with abnormal glucose tolerance; risk factor screening had 72.2% sensitivity and 35.0% specificity.
Conclusions:
- Risk factor screening demonstrates poor predictive value for GDM.
- Universal screening is a more reliable method for diagnosing GDM.
- The cost difference between universal and risk factor screening is negligible, favoring universal screening.
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