Joint position statement on universal screening for GDM in Europe by FIGO, EBCOG and EAPM

Hod, Moshe; Pretty, Matthew; Mahmood, Tahir

doi:10.1016/j.ejogrb.2018.05.037

Cited by 21 publications

(12 citation statements)

References 14 publications

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“…The IADPSG recommendation has been endorsed by the World Health Organization (WHO) [11], American Diabetic Association [44], American Association of Clinical Endocrinologist [45], and International Diabetes Federation. Recently, in Europe, the International Federation of Gynecology and Obstetrics [46] together with the European Board and College of Obstetrics and Gynecology and the European Association of Perinatal Medicine [47] accepted the IADPSG’s one-step universal screening approach considering the high rates of hyperglycemia in pregnancy in most populations and the poor sensitivity of selective screening test in addition to cost-effectiveness regarding the costs for type 2 diabetes developing in the future.…”

Section: Discussionmentioning

confidence: 99%

Gestational diabetes mellitus diagnosed at 24 to 28 weeks of gestation in older and obese Women: Is it too late?

2019

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Aim/BackgroundThe prevalence of elderly pregnancy and maternal obesity is increasing worldwide. In old and obese women, metabolic derangement affecting fetal growth might be present earlier than the diagnosis of gestational diabetes mellitus (GDM) or even before pregnancy. We thus investigated whether GDM diagnosed at 24–28 weeks of gestation had already affected fetal abdominal growth and, if so, whether elderly pregnancy and/or maternal obesity aggravate fetal abdominal obesity.MethodsWe retrospectively reviewed the medical records of 7820 singleton pregnant women who had been universally screened using a 50-g glucose challenge test (GCT) at 24–28 weeks of gestation, and underwent a 3-h 100-g oral glucose tolerance test (OGTT) if GCT were ≥140mg/dl. GDM and normal glucose tolerance (NGT) were diagnosed using the Carpenter-Coustan criteria. Fetal abdominal obesity was investigated by assessing the fetal abdominal overgrowth ratios (FAORs) of the ultrasonographically estimated gestational age (GA) of abdominal circumference per actual GA by the last menstruation period, biparietal diameter or femur length, respectively. Fetal abdominal overgrowth was defined as FAOR ≥ 90th percentile. The subjects were divided into four study groups: group 1 (age < 35 years and pre-pregnancy body mass index [BMI] < 25 kg/m2), group 2 (age < 35 years and ≥ 25), group 3 (age ≥ 35 years and BMI < 25), and group 4 (age ≥ 35 years and ≥ 25).ResultsThe overall prevalence of GDM was 5.1%, with old and obese group 4 exhibiting the highest prevalence (22.4%). FAORs were significantly higher in the fetus of those with GDM than in the NGT subjects. But, in the subgroup analysis, only old and nonobese group 3 and old and obese group 4 with GDM exhibited significantly higher FAORs than the NGT subjects. Also, risk of fetal abdominal overgrowth was increased in group 3 and 4 subjects with GDM but not in young and nonobese group 1 GDM. The risk of fetal abdominal overgrowth significantly increased with maternal age >35 years, pre-pregnancy BMI >20kg/m2, and HbA1c >37.7 mmol/mol (5.6%). In multivariate analyses, maternal age and HbA1c were significantly associated with FAORs.ConclusionGDM diagnosed at 24–28 weeks of gestation already affected fetal abdominal obesity in older and/or obese women, but not in younger and nonobese women. Our data suggest that selective screening and appropriate intervention of GDM earlier than 24–28 weeks of gestation might be necessary for high-risk old and/or obese women.

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Section: Discussionmentioning

confidence: 99%

Gestational diabetes mellitus diagnosed at 24 to 28 weeks of gestation in older and obese Women: Is it too late?

2019

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“…Nevertheless, most statements advocating universal screening do not mention the OGTT itself as a potential burden. 10,29,30 On the other hand, selective screening strategies usually do not have a 100% detection rate and so will automatically result in false negatives and, consequently, missed GDM cases. For selective screening strategies, there will always be a trade-off between a reduction of the false-positive rate (unnecessary OGTTs) and the false-negative rate (missed GDM cases).…”

Section: Discussionmentioning

confidence: 99%

“…8 Although several international guidelines promote universal screening, selective screening remains common practice in many developed countries including the Netherlands. [9][10][11] Women with an increased GDM risk can be identified either by a list comprising separate risk factors or by prediction models.…”

Section: Introductionmentioning

confidence: 99%

Adherence rates to a prediction tool identifying women with an increased gestational diabetes risk: An implementation study

Montfort

Scheepers

Dooren

et al. 2021

Intl J Gynecology & Obste

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“…Besides these overarching publications, committee members have contributed to scores of individual articles in peer‐reviewed publications addressing the existential links between maternal and newborn health and NCDs, as well as two supplements of the International Journal of Gynecology and Obstetrics (IJGO), and the Diabetes Research and Clinical Practice (DRCP) journal 17–28 …”

Section: Pncd Committee Initiativesmentioning

confidence: 99%

Connecting maternal and fetal medicine to non‐communicable disease prevention

Hod¹

2020

Intl J Gynecology & Obste

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Joint position statement on universal screening for GDM in Europe by FIGO, EBCOG and EAPM

Cited by 21 publications

References 14 publications

Gestational diabetes mellitus diagnosed at 24 to 28 weeks of gestation in older and obese Women: Is it too late?

Gestational diabetes mellitus diagnosed at 24 to 28 weeks of gestation in older and obese Women: Is it too late?

Adherence rates to a prediction tool identifying women with an increased gestational diabetes risk: An implementation study

Connecting maternal and fetal medicine to non‐communicable disease prevention

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