[Is there a standard biological screening of gestational diabetes mellitus?].
Universal screening for gestational diabetes mellitus (GDM) is contentious. There is insufficient evidence that universal screening for GDM substantially reduces perinatal complications such as cesarean section and Erb's palsy.However, risk assessment for GDM should be undertaken at the first prenatal visit and selective screening should be performed in high-risk women: diabetes mellitus in first-degree relatives, member of an ethnic group with a high prevalence of diabetes mellitus, body mass index > or 25 kg/m2, personal history of hyperglycemia or GDM, previous poor obstetric outcome. During the first trimester, a fasting glycemia over 1.05 g/l is associated with perinatal complications and should be treated. If fasting glycemia is below this level or unknown, or if glucosuria occurs, they should be re-tested between 24 and 28 weeks of gestation using a 75-g oral glucose load. The actual proposed glucose threshold values for GDM are, respectively, 1.05 and 1.55-1.60 g/l for fasting and 2 h.
Lepercq
J
J
Service de gynécologie-obstétrique, groupe hospitalier Cochin-Saint-Vincent-de-Paul, Paris, France. j.lepercq@svp.ap-hop-paris.fr
D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000235:genetics; D003924:Diabetes Mellitus, Type 2; D016640:Diabetes, Gestational / Q000150:complications / Q000175:diagnosis*; D005006:Ethnicity; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000453:epidemiology; D008403:Mass Screening; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012016:Reference Values; D012307:Risk Factors