Universal vs. risk factor‐based screening for gestational diabetes mellitus: detection rates, gestation at diagnosis and outcome

摘要: Summary Aims Gestational diabetes mellitus (GDM) is associated with adverse maternal and fetal outcome. Screening for GDM therefore recommended but the best screening method remains controversial. This prospective, randomized study compared a risk factor-based programme universally based one. Methods Subjects were at booking to one of two groups: factor group had 3-h 100-g oral glucose tolerance test (OGTT) 32 weeks if any was present; universal 50-g challenge performed their plasma 1 h was ≥ 7.8 mmol/l, formal OGTT then performed. Results Universal detected prevalence 2.7%, significantly more than 1.45% in screened (P < 0.03). Universal facilitated earlier diagnosis – mean gestation 30 ± 2.6 weeks vs. 33 ± 3.7 weeks (P < 0.05). A higher rate spontaneous vaginal delivery term, lower rates macrosomia, Caesarean section, prematurity, pre-eclampsia admission neonatal intensive care unit observed screened, early group. Conclusions Universal superior detecting cases, facilitating improved pregnancy