[Comparison of two routine screening strategies for gestational diabetes mellitus: the experience of Jean-Verdier Hospital].
OBJECTIVE
Screening strategies for gestational diabetes mellitus are controversial. Thus, we sought to determine the benefits of universal screening.


METHODS
Prospective study with 2121 women involved but 1610 really screened (75.9%). According to WHO's recommendations, the strategy implemented was one-step, universal screening with a 75g oral glucose tolerance test. Screening was performed between 24 and 28 weeks of gestation or earlier if risk factors were identified. Results were compared to previous year (2001) then only a selective screening was done.


RESULTS
Application of universal screening increased the prevalence of gestational diabetes mellitus (8.39% to 15.65%). Out of the 252 patients with gestational diabetes, 66 did not display any identified risk factor (26.19%). Some new risk factors have been identified: age>30, Asian, Indian or Pakistan ethnies. If these new risk factors were applied, this super selective screening would have a sensibility of 96%.


CONCLUSIONS
Universal screening seems to be the most appropriate routine screening strategy because it is difficult to know exactly the specific risk factors of a population to do a super selective screening.
Benchimol
M
M
Service de gynécologie-obstétrique, CHU Jean-Verdier, avenue du 14-Juillet, 93143 Bondy, France. michel.benchimol@jvr.ap-hop-paris.fr
Cosson
E
E
Faure
C
C
Carbillon
L
L
Attali
R
R
Uzan
M
M
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening; D010298:Parity; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012307:Risk Factors