title: Screening for gestational diabetes in the 21st century: a population-based cohort study in Israel.
abstract: Studies indicate that gestational diabetes mellitus (GDM) prevalence is increasing worldwide. We aimed to examine secular trends in GDM prevalence and screening practices over the last decade in Israel, and to identify changes in GDM risk factors.
  
  
  METHODS
  We collected data on all 367,247 pregnant women who were screened for GDM between 2000 and 2010 in Israel's second largest healthcare organization. Multivariable logistic regression analysis was used to identify risk factors for GDM.
  
  
  RESULTS
  GDM prevalence increased by 12%, from 3.8% in 2000 to 4.3% in 2010 and was accompanied by a 37% rise in the proportion screened directly by 100-gram oral glucose tolerance test without a prior 50-gram glucose challenge test (from 6.5% to 8.9%). During the study period there was an on-going increment in the proportion of pregnant women with one or more GDM risk factor, such as older age, low socioeconomic level, history of polycystic ovary syndrome or in vitro fertilization, which was all significantly (p < 0.05) associated with the risk of GDM.
  
  
  CONCLUSIONS
  The increasing risk of GDM in Israel can be explained by both rising prevalence of women with established risk factors, as well as shifting screening practices.
authors.affiliation: Medical Division, Maccabi Healthcare Services, 27 Ha’Mered Street, Tel Aviv, Israel. sella_tal@mac.org.il
authors.forename: Tal
authors.initials: T
authors.lastname: Sella
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
authors.forename: Uriel
authors.initials: U
authors.lastname: Elchalal
authors.forename: Aluma
authors.initials: A
authors.lastname: Chovel-Sella
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D019317:Evidence-Based Medicine; D005260:Female; D005307:Fertilization in Vitro; D005951:Glucose Tolerance Test; D006279:Health Maintenance Organizations; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000150:complications; D011247:Pregnancy; D012307:Risk Factors; D012959:Socioeconomic Factors