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1Center for Perinatal and Women's Health Research, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, USA.
Gestational diabetes mellitus is associated with increased neonatal morbidities and higher cesarean delivery rates; women with gestational diabetes mellitus are at increased risk for type II diabetes mellitus later in life. The current recommendation for screening includes a glucose tolerance test either early in pregnancy and/or at 24-28 weeks' gestation followed by a diagnostic 100-g oral 3-hour glucose tolerance test with a rate of 5%. The results of a large prospective observational study (HAPO study) and 2 randomized trials lead the International Association of Diabetes in Pregnancy Study Group to recommend a 1-stage screening and diagnosis method that includes a 75-g 2-hour glucose tolerance test that will result in an 18% gestational diabetes mellitus rate. However, there is uncertainty about the clinical implications of the adoption of the latter recommendation.
Gestational diabetes mellitus is associated with increased neonatal morbidities and higher cesarean delivery rates; women with gestational diabetes mellitus are at increased risk for type II diabetes mellitus later in life. The current recommendation for screening includes a glucose tolerance test either early in pregnancy and/or at 24-28 weeks' gestation followed by a diagnostic 100-g oral 3-hour glucose tolerance test with a rate of 5%. The results of a large prospective observational study (HAPO study) and 2 randomized trials lead the International Association of Diabetes in Pregnancy Study Group to recommend a 1-stage screening and diagnosis method that includes a 75-g 2-hour glucose tolerance test that will result in an 18% gestational diabetes mellitus rate. However, there is uncertainty about the clinical implications of the adoption of the latter recommendation.
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