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Screening for gestational diabetes: a systematic review and meta-analysis
Gabriela J Prutsky1, Juan Pablo Domecq, Vishnu Sundaresh
1MD, MPH, Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905. Murad.mohammad@mayo.edu.
The Journal of Clinical Endocrinology and Metabolism
|October 24, 2013
Summary
Screening tests for gestational diabetes mellitus (GDM) help identify high-risk pregnancies, but may lead to unnecessary treatment for some women. Evidence supports their use in managing pregnancy outcomes.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Gestational diabetes mellitus (GDM) is hyperglycemia first recognized during pregnancy.
- The optimal screening time and methods for GDM remain unclear.
Purpose of the Study:
- To appraise evidence on gestational diabetes mellitus (GDM) screening.
- Evaluate accuracy, correlation with adverse outcomes, and harms of GDM screening tests.
Main Methods:
- Systematic review of randomized controlled trials and observational studies.
- Searched multiple databases (Ovid Medline, EMBASE, Cochrane, Web of Science, Scopus, PsycInfo, CINAHL) through May 2011.
- Independent data abstraction by two reviewers.
Main Results:
- No RCTs directly measured feto-maternal outcomes for GDM screening.
- The 1-hour 50-g glucose challenge test is common, with results linked to adverse outcomes (P < .001).
- Positive screening criteria (Carpenter and Coustan, National Diabetes Data Group) associated with macrosomia and gestational hypertension.
Conclusions:
- Indirect evidence supports using current GDM screening tests to identify pregnancies at risk of adverse outcomes.
- Screening may lead to unnecessary GDM treatment for some pregnant individuals.
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