Risk factor-based selective screening program for gestational diabetes mellitus in Siriraj Hospital: result from clinical practice guideline.
A clinical practice guideline for the screening and diagnosis of gestational diabetes mellitus (GDM) is currently implemented at Siriraj Hospital. During the year 2000, a total of 9325 pregnant women were screened for clinical risk factors during their first antenatal visits, and 3770 had at least 1 risk. After the 50 g glucose challenge test and 100 g oral glucose tolerance test, GDM was diagnosed in 235 women. The incidence of GDM was 6.2 per cent (95% CI 5.5-7.1) among high-risk pregnant women, and 2.5 per cent (95% CI 2.2-2.9) of all pregnant women. Significant risk factors identified from the present study were family history of DM (adjusted OR 1.86, 95% CI 1.38-2.51), age > or = 30 years (adjusted OR 2.41, 95% CI 1.72-3.39), history of unexplained intrauterine fetal death (adjusted OR 4.30, 95% CI 2.04-9.04), and obesity (adjusted OR 2.83, 95% CI 1.88-4.25). The risk of developing GDM also increased when more than 1 clinical risk factor was identified. The results support the value of this screening program for GDM. Every obstetrician should be aware of the need to screen for GDM in every pregnant woman and a similar program should also be introduced to other settings.
Sunsaneevithayakul
Prasert
P
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Boriboohirunsarn
Dittakarn
D
Sutanthavibul
Anuwat
A
Ruangvutilert
Pornpimol
P
Kanokpongsakdi
Sujin
S
Singkiratana
Darunee
D
Bunyawanichkul
Srisawat
S
D000328:Adult; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology