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Is selective screening for gestational diabetes mellitus worthwhile everywhere?
R Corcoy1, A García-Patterson, E Pau
1Department of Endocrinology, Hospital de Sant Pau, Sant Antoni Ma Claret 167, Barcelona 08025, Spain. rcorcoy@santpau.es
Acta Diabetologica
|January 22, 2005
Summary
Selective screening for gestational diabetes mellitus (GDM) reliably identifies low-risk women. However, this approach is impractical as it excludes only a small portion of the pregnant population, complicating screening policies.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Gestational diabetes mellitus (GDM) diagnosis guidelines have evolved, with selective screening proposed by the Fourth Workshop.
- Previous screening strategies involved universal testing across multiple pregnancy periods.
Purpose of the Study:
- To evaluate the clinical utility and feasibility of selective screening for GDM in a specific healthcare setting.
- To determine the prevalence of low-risk characteristics for GDM in pregnant women.
Main Methods:
- Analysis of GDM prevalence and low-risk characteristics in a cohort of 1635 women diagnosed with GDM (1986-1998).
- Assessment of low-risk criteria in 917 women delivering in 1992.
- Comparison of universal screening versus selective screening strategies.
Main Results:
- Only 7.0% of the general pregnant population exhibited all low-risk characteristics for GDM.
- A significantly lower proportion, 1.3%, of women with GDM had all low-risk characteristics (p<0.001).
- Selective screening effectively identifies women at low risk, but a negligible percentage would be excluded.
Conclusions:
- Selective GDM screening is reliable for identifying low-risk individuals in this population.
- Implementing selective screening based on current guidelines would overly complicate the screening policy due to the small number of women eligible for exclusion.