title: Gestational diabetes mellitus diagnosed by screening or symptoms: does it matter?
abstract: OBJECTIVE
  To investigate whether outcome differs between pregnancies complicated by gestational diabetes mellitus (GDM), which was either detected by risk-factor based screening when no clinical signs are apparent (screening-group) or due to clinical signs of hyperglycemia (e.g. accelerated fetal growth or hydramnios) (diagnosis-group).
  
  
  METHODS
  A retrospective cohort of 249 patients with GDM treated between 2006 and 2009 were identified: 74 in the diagnosis-group and 175 in the screening-group. Fetal macrosomia was defined as an abdominal circumference (FAC) >90th percentile at the time of diagnosis of GDM. Large for gestational age (LGA) was defined as a birthweight >90th percentile, corrected for gestational age, parity and sex.
  
  
  RESULTS
  GDM was diagnosed 4 weeks later in the diagnosis-group. At diagnosis of GDM, more infants in the diagnosis-group had a FAC >p90 and at birth more infants in this group were LGA.
  
  
  CONCLUSIONS
  GDM diagnosed by screening is associated with a lower incidence of fetal and neonatal macrosomia than GDM diagnosed by clinical symptoms. A later diagnosis of GDM is more prevalent in presumed low-risk pregnancies. These results favour a policy of routine screening.
authors.affiliation: University Medical Center Utrecht, Division Woman & Baby, Utrecht, The Netherlands. nurahhammoud@gmail.com
authors.forename: Nurah M
authors.initials: NM
authors.lastname: Hammoud
authors.forename: Harold W
authors.initials: HW
authors.lastname: de Valk
authors.forename: Douwe H
authors.initials: DH
authors.lastname: Biesma
authors.forename: Gerard H A
authors.initials: GH
authors.lastname: Visser
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies