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Clinical experience with a screening program for gestational diabetes

J P Lavin, T P Barden, M Miodovnik

    American Journal of Obstetrics and Gynecology
    |November 1, 1981
    PubMed
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    Screening pregnant women for gestational diabetes using a glucose challenge test (GCT) showed similar detection rates regardless of risk factors. Early or routine screening at 28-32 weeks effectively identifies abnormal glucose metabolism.

    Area of Science:

    • Obstetrics and Gynecology
    • Endocrinology
    • Maternal-Fetal Medicine

    Background:

    • Gestational diabetes mellitus (GDM) poses risks to both mother and fetus.
    • Effective screening strategies are crucial for early detection and management.
    • Risk factor-based versus routine screening timing in pregnancy requires evaluation.

    Purpose of the Study:

    • To compare the effectiveness and incidence of gestational diabetes detection between two screening protocols.
    • To evaluate the utility of early screening in high-risk pregnancies versus routine screening in all pregnancies.

    Main Methods:

    • A cohort of 2,077 pregnant women was screened for abnormal glucose metabolism.
    • Group 1 (959 women) had risk factors and were screened initially and at 28-32 weeks if normal.

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  • Group 2 (1,118 women) were screened routinely at 28-32 weeks using a glucose challenge test (GCT) and oral glucose tolerance test (GTT).

    • Main Results:

    • Group 1: 7.2% abnormal GCT, 1.5% abnormal GTT.
    • Group 2: 6.1% abnormal GCT, 1.4% abnormal GTT.
    • Incidences of abnormal glucose metabolism were not statistically different between the groups.

    Conclusions:

    • Screening timing and risk factor assessment did not significantly alter gestational diabetes detection rates.
    • Both early/risk-based and routine late-pregnancy screening protocols yield comparable results.
    • The cost-effectiveness of screening was estimated at $4.75 per patient and $328.96 per case detected.