Early universal screening for gestational diabetes mellitus

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Public Health

Background:

• Gestational diabetes mellitus (GDM) poses significant risks to both mother and fetus.
• Early detection and management are critical for improving pregnancy outcomes.
• Universal screening strategies are increasingly being evaluated for their effectiveness.

Purpose of the Study:

• To determine the prevalence of Gestational diabetes mellitus (GDM) in a cohort of pregnant Indian women.
• To assess the impact and effectiveness of early universal screening for GDM.
• To identify risk factors associated with GDM.

Main Methods:

• A cohort of 1106 pregnant women underwent universal screening for GDM at their first prenatal visit.
• Screening involved a 50-gram glucose challenge test (GCT), followed by a 75-gram oral glucose tolerance test (OGTT) for positive cases.
• Diagnostic criteria from the American Diabetes Association (ADA) and IADPSG were utilized.

Main Results:

• The overall prevalence of GDM was found to be 23.3%.
• GDM showed a significant association with increasing maternal age, parity, infertility, and a family history of diabetes.
• The study identified specific timings for GDM diagnosis across trimesters, with a notable percentage diagnosed in the third trimester.

Conclusions:

• The prevalence of GDM is high in the Indian population, underscoring the need for effective screening protocols.
• Universal screening for GDM at the first prenatal visit is superior to risk-factor-based screening for early detection.
• Early diagnosis facilitates timely intervention, potentially mitigating adverse pregnancy outcomes associated with GDM.