title: [Relevance of gestational diabetes mellitus screening and comparison of selective with universal strategies].
abstract: OBJECTIVE
  To assess the relevance of gestational diabetes mellitus (GDM) screening policy and to compare selective with universal screening.
  
  
  METHODS
  Systematic review of all French and English languages publications in Medline and Cochrane Databases, published since 1990.
  
  
  RESULTS
  Maternal hyperglycemia is associated with increased maternal and neonatal complications. The 75 g OGTT (Oral Glucose Tolerance Test) is a valid and reliable test for GDM diagnosis. Treatment of GDM reduces perinatal complications. Selective screening allows to limit false positive rate and to concentrate medical resources. Nevertheless, screening might be more difficult to perform and lead to miss up to 45% of GDM cases. Universal screening offers higher sensitivity but leads to more therapeutic interventions whose benefit and cost/efficiency ratio need to be estimated in low risk women.
  
  
  CONCLUSIONS
  The benefits of GDM screening and treatment have only been proven for women with GDM risk factors. Their relevance in women without risk factor remains controversial.
authors.affiliation: Hôpital l'Archet, Centre hospitalier universitaire de Nice, Service d'endocrinologie-maladies métaboliques-médecine de la reproduction, 06202 Nice, France.
authors.forename: S
authors.initials: S
authors.lastname: Hiéronimus
authors.forename: J-P
authors.initials: JP
authors.lastname: Le Meaux
mesh_terms: D003362:Cost-Benefit Analysis; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods; D011247:Pregnancy; D015203:Reproducibility of Results