Relevance of gestational diabetes mellitus screening and comparison of selective with universal strategies

Hiéronimus, S.; Meaux, J.-P. Le

doi:10.1016/j.diabet.2010.11.010

Cited by 19 publications

(10 citation statements)

References 28 publications

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“…Overall, we showed that the risk factors proposed in the French guidelines significantly predicted GDM, although the clinical relevance appears to be low, since 34.7% of the women with GDM would have been missed without universal screening, in line with previous reports (2). Of note, Jensen et al (22) had reported excellent screening performances of criteria very close to ours.…”

Section: Discussionsupporting

confidence: 90%

“…A universal screening has been recommended, but a selective screening, based on the presence of risk factors, has been used as well (2). Using selective screening may lead to missing up to 45% of GDM cases (3).…”

mentioning

confidence: 99%

“…Using selective screening may lead to missing up to 45% of GDM cases (3). On the other hand, selective screening could help to concentrate medical resources on subjects with the highest risk of complications (2), especially those with a high BMI (4). This is crucial, as the cost-efficacy ratio of GDM screening still needs to be evaluated in women with no risk factors (5).…”

mentioning

confidence: 99%

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Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects

et al. 2013

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OBJECTIVEWe aimed to evaluate a selective screening strategy for gestational diabetes mellitus (GDM) based on the presence of risk factors: BMI ≥25 kg/m2, age ≥35 years, family history of diabetes, personal history of GDM, or birth of a child with macrosomia.RESEARCH DESIGN AND METHODSOf 20,630 deliveries between 2002 and 2010, we selected 18,775 deliveries in women with no known diabetes and for whom all risk factors were known. GDM was universally screened and defined as fasting plasma glucose level ≥5.3 mmol/L and/or 2-h postload (75 g) glucose level ≥7.8 mmol/L.RESULTSThe prevalence of at least one risk factor has increased since 2002 (P < 0.001) from 51.7 to 61.5%, with no change in the GDM prevalence (mean 14.4%, intention to screen). At least one risk factor was present in 58.5% of women who represented 65.3% of all those with GDM. The presence of risk factors was significantly associated with GDM (odds ratio 1.4 [95% CI 1.3–1.5], P < 0.001) and with GDM-related events (preeclampsia/large for gestational age/dystocia) (P < 0.001) with the following incidences: no GDM/no risk factor 8.8%, no GDM/risk factor 11.1%, GDM/no risk factor 16.7%, and GDM/risk factor 18.2%.CONCLUSIONSThe presence of risk factors increased during the last decade. This condition is predictive of GDM and GDM-related events. However, a selective screening would lead to missing one-third of the women with GDM who, even without risk factors, had more events than women without GDM. Therefore, these data stand against the present selective screening currently proposed in the French guidelines.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

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confidence: 99%

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Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects

et al. 2013

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“…Another controversy, which has received less attention, is whether selective or universal screening should be offered [14,15]. In France, practice guidelines issued in December 2010 recommended 1-step screening with IADPSG thresholds, but restricted to women with pre-defined risk factors for GDM [16].…”

Section: Introductionmentioning

confidence: 99%

Selective rather than universal screening for gestational diabetes mellitus?

Miailhe¹,

Kayem²,

Girard³

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Il n'y a donc pas d'arguments suffisants pour recommander un dépistage systématique. Dans tous les cas, la déci-sion de dépister ou de ne pas dépister le DG doit faire l'objet d'une évaluation et d'une information individuelles [30].…”

Section: Effets Du Traitementunclassified

Diabète gestationnel, surpoids, obésité

Lepercq

2011

Rev. med. perinat.

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Relevance of gestational diabetes mellitus screening and comparison of selective with universal strategies

Cited by 19 publications

References 28 publications

Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects

Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects

Selective rather than universal screening for gestational diabetes mellitus?

Diabète gestationnel, surpoids, obésité

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