title: Screening for gestational diabetes in the Lombardy region: A population-based study.
abstract: OBJECTIVE
  As the treatment of hyperglycaemia during pregnancy with diet or insulin reduces the risk of adverse maternal outcomes and perinatal complications, screening for gestational diabetes mellitus (GDM) is included, albeit to variable extents, in all guidelines of care for pregnant women. The aim of the present investigation was to estimate the proportion of pregnancies screened for GDM in Lombardy between 2007 and 2010, and to identify predictors of screening.
  
  
  METHODS
  A retrospective cross-sectional study using regional healthcare utilization databases of Lombardy was conducted. The study included all residents of Lombardy without pregestational diabetes who delivered between 1 January 2007 and 31 December 2010. The proportion of pregnancies with at least one screening test for GDM was calculated, along with the odds ratios and 95% confidence intervals associated with selected covariates for GDM screening.
  
  
  RESULTS
  Of the 362,818 pregnancies included in the sample, 30% were screened for GDM. The proportion of pregnancies screened increased slightly from 2007 (27%) to 2010 (33%) and with maternal age (from 28% among women<25 years to 32% among those ≥35 years), and varied widely across local health management organizations (HMOs) of residence (range: 20% to 68%). Socioeconomic indicators (education, immigrant status), obstetric history and prepregnancy hypertension were independent predictors of GDM screening.
  
  
  CONCLUSIONS
  The study finding of a low rate of pregnant women screened for GDM among residents of Lombardy supports the need for programmes to improve training of healthcare professionals, to raise women's awareness of GDM and to eliminate barriers to GDM screening.
authors.affiliation: Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Nicotra
authors.affiliation: Università Vita Salute San Raffaele, Department of Internal Medicine, Division of General Internal Medicine, Diabetes and Endocrine Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Molinari
authors.affiliation: Università Vita Salute San Raffaele, Department of Internal Medicine, Division of General Internal Medicine, Diabetes and Endocrine Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Dozio
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy.
authors.forename: M T
authors.initials: MT
authors.lastname: Castiglioni
authors.affiliation: Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Ibrahim
authors.affiliation: Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy. Electronic address: antonella.zambon@unimib.it.
authors.forename: A
authors.initials: A
authors.lastname: Zambon
authors.affiliation: Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Corrao
authors.affiliation: Division of Immunology, Transplantation and Infectious Diseases, Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Scavini
mesh_terms: D000328:Adult; D001724:Birth Weight; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cross-sectional study; Gestational diabetes mellitus; Healthcare utilization databases; Oral glucose tolerance test; Predictors; Screening