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Screening for gestational diabetes mellitus by a model based on risk indicators: a prospective study
Dorte M Jensen1, Lars Mølsted-Pedersen, Henning Beck-Nielsen
1Department of Endocrinology, Odense University Hospital, Kløvervaenget 6, DL-5000 Odense, Denmark. DorteMJ@dadlnet.dk
American Journal of Obstetrics and Gynecology
|November 25, 2003
Summary
A new screening model using clinical risk indicators for gestational diabetes mellitus (GDM) shows promising results. This approach could potentially reduce the need for universal screening in pregnant women.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Gestational diabetes mellitus (GDM) is a significant concern in pregnancy.
- Effective screening methods are crucial for early detection and management.
- Clinical risk indicators offer a potential avenue for targeted screening.
Purpose of the Study:
- To prospectively evaluate a screening model for gestational diabetes mellitus (GDM) based on clinical risk indicators.
- To assess the feasibility and accuracy of this model in a large cohort of pregnant women.
Main Methods:
- A prospective, multicenter study involving 5235 pregnant women.
- Routine diagnostic testing (2-hour 75-g oral glucose tolerance test) for women with risk indicators.
- Offered testing to women without risk indicators as part of the study.
Main Results:
- The calculated prevalence of GDM was 2.4%.
- The screening model demonstrated a sensitivity of 80.6% and a specificity of 64.8%.
- Forty-four percent of women underwent testing, while 43% declined participation.
Conclusions:
- The clinical risk indicator model's sensitivity is comparable to universal screening methods under ideal conditions.
- This model has the potential to avoid unnecessary screening and diagnostic testing in approximately two-thirds of pregnant women.
- The findings support the use of clinical risk indicators for a more targeted GDM screening approach.