Screening and diagnosis of gestational diabetes: a hybrid method
DOI:
https://doi.org/10.18203/2320-6012.ijrms20230567Keywords:
Diabetes, Gestational, Curve, Complications, Screening, DiagnosisAbstract
Background: In Mexico the gestational diabetes prevalence varies between 4 and 13%. The main purpose of this study is to determine the prevalence of gestational diabetes, the relevance of its risk factors, and its repercussions in pregnancy with a hybrid diagnostic method.
Methods: This prospective, longitudinal, and observational study includes 347 pregnant women. Screening for gestational diabetes was performed with the O’Sullivan test, with a cut-off point of 140 mg/dL of glucose, followed by a 75-gram oral glucose tolerance test in patients with an abnormal screening test. The diagnosis was made with one or more abnormal results. Different variables were evaluated in these patients; from risk factors, to complications of gestational diabetes.
Results: Of the 347 patients studied, 77 (22.2%) had a positive screen and 34 patients were confirmed with gestational diabetes (9.8%). A body mass index greater than or equal to 25 increased the relative risk by 2.52, the history of macrosomia by 4.10, a maternal age greater than or equal to 36 years by 2.54, and the presence of a twin pregnancy by 6.94. Regarding complications, there was an increase in prevalence of macrosomia (RR=4.09).
Conclusions: The prevalence of gestational diabetes, using the combination of the two existing classical methods, is similar to that reported in other national and international studies, while also avoiding overdiagnosis, over-monitoring, and reducing typical discomforts that may come by using the one-step method.
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References
Guariguata L, Linnenkamp U, Beagley J. Global estimates of the prevalence of hyperglycemia in pregnancy. Diabetes Res Clin Pract. 2014;103:176.
Ramirez T. Diabetes Gestacional. Experiencia en una institución de tercer nivel de atención. Ginecol Obstet Mex. 2005;73:484-91.
Hinojosa M, Hernandez F. Prevalencia de diabetes mellitus gestacional en el Hospital Juárez de México. Rev Hosp Jua Mex. 2010;77(2):123-8.
HAPO Study Cooperative Research Group, Metzger BE, Lowe LP. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2007;358:1991.
Scholtens DM, Kuang A, Lowe LE. Hyperglycemia and adverse pregnancy outcome follow-up study (HAPO FUS): maternal glycemia and childhood glucose metabolism. Diab Care. 2019;42:381.
Moyer VA. Screening for gestational diabetes mellitus: U.S. preventive services task force recommendation statement. U.S. Preventive Services Task Force. Ann Intern Med. 2014;160:414-20.
Danilenko-Dixon DR, Van Winter JT. Universal versus selective gestational diabetes screening: application of 1997 american diabetes association recommendations. Am J Obstet Gynecol. 1999;181: 798.
Lowe LE. Classification and diagnosis of diabetes: standard of medical care in diabetes-2012. Diab Care. 2021;44:S15.
Hernandez F. Gestational diabetes mellitus. Obstet Gynecol 2018:131:e49.
O’Sullivan JB, Mahan CM, Charles D,m Dandrow RV. Screening criteria for high-risk gestational diabetic patients. Am J Obstet Gynecol. 1973;116:8905-9.
Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P. International association of diabetes and pregnancy study groups recommendations of the diagnosis and classification of hyperglycemia in pregnancy. Diab Care. 2010;33:676-82.
Horvath K, Koch K, Jeitler K, Matuas E, Bender R, Bastian H, et al. Effects of treatment in Women with gestational diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;340:c1395.
Van Winter JT. Classification and diagnosis of diabetes. Diab Care. 2017;40:114-9.
Rumbold AR, Crowther CA. Women’s experiences of being screened for gestational diabetes mellitus. Aus N Z J Obstet Gynaecol. 2002;42:131-7.
Agarwal MM, Punnose J, Dhatt GS. Gestational diabetes: problems associated with the oral glucose tolerance test. Diabetes Res Clin Pract. 2004;63:73.
Thompson D, Berger H, Feig D, et al. Diabetes and pregnancy. Can J Diab. 2013;37:S1-9.
Reporting guideline checklist. Available at: https://www.equator-network.org/wp-content/uploads/2015/03/STARD-2015-checklist.pdf. Accessed on 20 November 2022.
Ramirez TM. Diabetes mellitus gestacional. Experiencia en una institución de tercer nivel de atención. Ginecol Obstet Mex. 2005;73:484-91.
Rolnik DL, Wright D, Poon LCY, Syngelaki A, O'Gorman N, de Paco Matallana C, et al. ASPRE trial: performance of screening for preterm pre-eclampsia. Ultrasound Obstet Gynecol. 2017;50(4):492-5.
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