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Endocrine

pp 1–6 | Cite as

Universal vs. risk-factor-based screening for gestational diabetes—an analysis from a 5-Year Portuguese Cohort

  • Claudia Matta-Coelho
  • Ana Margarida Monteiro
  • Vera Fernandes
  • Maria Lopes Pereira
  • Portuguese Diabetes and Pregnancy Study Group
  • Selma B. Souto
Original Article

Abstract

Purpose

The criteria to screen for Gestational Diabetes Mellitus are not internationally consensual. In opposition to the universal screening performed in Portugal, certain countries advocate a risk-factor-based screening. We aim to compare obstetric and neonatal outcomes in pregnant women with and without risk factors treated for Gestational Diabetes Mellitus.

Methods

Retrospective and multicentric study of 12,006 pregnant women diagnosed with Gestational Diabetes Mellitus between 2011 and 2015, in Portugal. Gestational Diabetes Mellitus was diagnosed according to the International Association of the Diabetes and Pregnancy Study Groups criteria. Risk factors: body mass index > 30kg/m2, history of Gestational Diabetes Mellitus, history of macrossomic newborn (birth weight > 4000 g) or first-degree relatives with Type 2 Diabetes Mellitus. Exclusion criteria: lack of data concerning risk factors (n = 1563).

Results

At least one risk factor was found in 68.2% (n = 7123) pregnant women. Pregnant women with risk factors were more frequently medicated with insulin (p < 0.001), caesarean section was more commonly performed (p < 0.001), their newborns were more frequently large-for-gestational-age (p < 0.001) and neonatal morbidity was higher (p = 0.040) in comparison to pregnant women without risk factors. The Diabetes Mellitus reclassification test showed an increased frequency of intermediate hyperglycaemia and Diabetes Mellitus in women with risk factors (p < 0.001).

Conclusion

Almost one-third of pregnant women would have remained undiagnosed if risk-based-factor screening were implemented in Portugal. Women without risk factors presented fewer obstetric and neonatal complications. However, more than one third required insulin therapy.

Keywords

Diabetes gestational Risk factors Diagnosis Mass screening 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Endocrinology DepartmentHospital de BragaBragaPortugal
  2. 2.Center for Health Technology and Services Research (CINTESIS)University of PortoPortoPortugal
  3. 3.Portuguese Society of DiabetologyPortoPortugal

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