Universal rather than selective screening for gestational diabetes mellitus may improve fetal outcomes

Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women

“…(7, 16) However, it is estimated that risk based screening will miss up to 30% of women with GDM as not all women with GDM have identifiable risk factors. (17) The International Diabetes Federation (IDF), American College Obstetricians and Gynaecologists and the Australasian Diabetes in Pregnancy Society recommend universal screening unless a selective process based on risk is deemed more appropriate. (18,19) (20) The aims of this study were to assess compliance with risk based screening for GDM in a prospective international cohort of nulliparous women conducted in settings where risk factor based screening is normal practice.…”

Estimating the risk of gestational diabetes mellitus: a clinical prediction model based on patient characteristics and medical history

“…[6][7][8] The sensitivity and specificity are both considered to be low, leaving women with GDM undiagnosed on the one hand, and leading to unnecessary testing in healthy women on the other.…”

Can fetal macrosomia be predicted and prevented?

“…The overall effect of treatment modalities is stricter glycemic control and subsequent reduction in BW. 24 This may also explain the plateau in the number of macrosomic infants. In the United States, there is a trend toward universal screening for GDM.…”

“…Therefore, even greater numbers of women are diagnosed with GDM, and their pregnancies are managed ideally within strict glycemic control. 24 In addition to the regulation of hyperglycemia, the pregnancy complicated by GDM is unlikely to progress past 38 weeks gestation especially in the case of insulin-dependent GDM. 25 As a result, these fetuses are not being given the opportunity for a growth surge in the latter part of pregnancy and in the post dates period.…”