Screening for gestational diabetes mellitus by a model based on risk indicators: a prospective study.
OBJECTIVE
This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators.


METHODS
In a prospective multicenter study with 5235 consecutive pregnant women, diagnostic testing with a 2-hour 75-g oral glucose tolerance test was routinely performed in women with risk indicators and offered to women without risk indicators as part of the study.


RESULTS
Forty-four percent of the women underwent testing, 43% declined participation, 6% did not speak Danish, and 7% could not be contacted. By extrapolation of the results from tested women to the whole group in question, a 2.4% prevalence of gestational diabetes mellitus was calculated. Sensitivity and specificity of the model was 80.6 (73.7-87.6) and 64.8 (63.5-66.1), respectively (95% CIs).


CONCLUSIONS
Under ideal conditions, sensitivity of the model was comparable with universal screening by fasting glucose or a 1-hour 50-g glucose challenge test. Both screening and diagnostic testing could be avoided in two thirds of all pregnant women.
Jensen
Dorte M
DM
Department of Endocrinology, Odense University Hospital, Kløvervaenget 6, DL-5000 Odense, Denmark. DorteMJ@dadlnet.dk
Mølsted-Pedersen
Lars
L
Beck-Nielsen
Henning
H
Westergaard
Jes G
JG
Ovesen
Per
P
Damm
Peter
P
D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening; D008962:Models, Theoretical; D011237:Predictive Value of Tests; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity