Selective or universal diagnostic testing for gestational diabetes mellitus.
OBJECTIVE
To estimate the effect of selective diagnostic testing for gestational diabetes mellitus (GDM): (1) based on evaluation of risk factors; and (2) based on the recommendations of The Fourth Workshop-Conference on GDM.


METHODS
A retrospective study was performed of 147 pregnancies complicated by GDM delivered in Kaunas University of Medicine Hospital. The maternal and fetal outcomes and the main risk factors were compared with the same data of a randomly selected 300 women with normal glucose tolerance testing. Logistic regression was used to estimate the odds ratios with 95% confidence interval (CI).


RESULTS
The prevalence of all risk factors was significantly higher in the group with GDM, but 29 of these women (23.13%) had no risk factors. Sixteen women (10.9%) with GDM were at low risk and would remain undiagnosed if selective screening would be used.


CONCLUSIONS
The recommendations not to test low-risk group women are doubtful and require further examination whereas universal screening of all pregnant women would be justified.
Baliutaviciene
D
D
Department of Obstetrics and Gynecology, Kaunas University of Medicine, Kaunas, Lithuania.
Petrenko
V
V
Zalinkevicius
R
R
D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000209:etiology*; D003951:Diagnostic Errors / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D005951:Glucose Tolerance Test / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening / Q000592:standards* / Q000706:statistics & numerical data; D016017:Odds Ratio; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors