Skip to main content
SpringerLink
Log in

Screening for gestational diabetes: usefulness of clinical risk factors

  • Original Article
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

There is little consensus regarding selective or universal screening for gestational diabetes. The aim of this study is to determine the influence of risk factors on incidence of GDM in Iranian population by using 75 g OGTT.

Methods

At the first prenatal visit, 924 pregnant women were assessed for age, BMI, obstetric history, family history of diabetes, and diagnosis of polycystic ovary syndrome before pregnancy. All eligible women underwent 2-h 75 g oral glucose tolerance test. Gestational diabetes was diagnosed according to American Diabetes Association criteria.

Results

During study period, 68 [7.4% (95% CI 5.9–9.2)] cases of GDM were found. Age, pre-pregnancy BMI, and family history of DM were the independent clinical predictors of GDM. In women with age <25, BMI ≤ 24.9, and negative family history for diabetes, the risk of GDM was 0.008 (0.001–0.044). This risk increased to 0.250 (0.102–0.495) in women with age ≥30, BMI ≥ 30 and positive family history for diabetes. With selective screening and without screening in low risk group, we will do 13.6% (126 of 924) less screening tests while missing potentially 1.5% (1 of 68) of GDM cases.

Conclusion

Age, BMI, and family history of diabetes were independent risk factors in developing gestational diabetes. Concerning these factors, we do not miss substantial number of GDM cases with selective screening.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

GDM:

Gestational diabetes mellitus

OGTT:

Oral glucose tolerance test

ADA:

American Diabetes Association

GCT:

Glucose challenge test

References

  1. American Diabetes Association (2007) Diagnosis and classification of diabetes mellitus. Diabetes Care 30(Suppl 1):S42–S47

    Article  Google Scholar 

  2. US Preventive Services Task Force (2008) Screening for gestational diabetes mellitus: US Preventive Services Task Force recommendation statement. Ann Intern Med 148:759–765

    Google Scholar 

  3. Larijani B, Hossein-nezhad A, Rizvi SW et al (2003) Cost analysis of different screening strategies for gestational diabetes mellitus. Endocr Pract 9:504–509

    PubMed  Google Scholar 

  4. Keshavarz M, Cheung NW, Babaee GR et al (2005) Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diabetes Res Clin Pract 69:279–286

    Article  PubMed  Google Scholar 

  5. Shirazian N, Mahboubi M, Emdadi R et al (2008) Comparison of different diagnostic criteria for gestational diabetes mellitus based on the 75-g oral glucose tolerance test: a cohort study. Endocr Pract 14:312–317

    PubMed  Google Scholar 

  6. Hadaegh F, Tohidi M, Harati H et al (2005) Prevalence of gestational diabetes mellitus in southern Iran (Bandar Abbas City). Endocr Pract 11:313–318

    PubMed  Google Scholar 

  7. Naylor CD, Sermer M, Chen E et al (1997) Selective screening for gestational diabetes mellitus. Toronto Trihospital Gestational Diabetes Project Investigators. N Engl J Med 337:1591–1596

    Article  CAS  PubMed  Google Scholar 

  8. Poyhonen-Alho MK, Teramo KA, Kaaja RJ et al (2005) 50gram oral glucose challenge test combined with risk factor-based screening for gestational diabetes. Eur J Obstet Gynecol Reprod Biol 121:34–37

    Article  PubMed  Google Scholar 

  9. Moses RG, Moses J, Davis WS (1998) Gestational diabetes: do lean young caucasian women need to be tested? Diabetes Care 21:1803–1806

    Article  CAS  PubMed  Google Scholar 

  10. Sermer M, Naylor CD, Farine D et al. (1998) The Toronto Tri-Hospital Gestational Diabetes Project A preliminary review. Diabetes Care 21(Suppl 2):B33-42.:B33-B42

    Google Scholar 

  11. Zawadski JK, Dunaif A (1992) Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GE (eds) Hershman SM (series ed) Polycystic ovary syndrome, current issues in endocrinology and metabolism. Blackwell Scientific Publications, Boston, p 377

  12. Maghbooli Z, Hossein-Nezhad A, Rahmani M et al (2007) Relationship between leptin concentration and insulin resistance. Horm Metab Res 39:903–907

    Article  CAS  PubMed  Google Scholar 

  13. Azizi F, Azadbakht L, Mirmiran P (2005) Trends in overweight, obesity and central fat accumulation among Tehranian adults between 1998–1999 and 2001–2002: Tehran Lipid and Glucose Study. Ann Nutr Metab 49:3–8

    Article  CAS  PubMed  Google Scholar 

  14. Barzin M, Sarbakhsh Eskandary P, Hosseinpanah F (2008) Trend of obesity and abdominal obesity in Tehrainian adults population, Unpublished data from Tehran Lipid and Glucose Study

  15. HAPO Study Cooperative Research Group (2002) The hyperglycemia and adverse pregnancy outcome (HAPO) study. Int J Gynaecol Obstet 78:69–77

    Article  Google Scholar 

Download references

Acknowledgments

This research has been supported by Islamic Azad University, Tehran Medical Branch grant. We thank Sara Niktorreh and Leila Molavi for data collection and entry and Dr. Shadi Kolahdoozan for help with editing.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Islamic Azad University, Tehran Medical Branch, P.O. Box 19395-1495, Zargandeh, Dr. Shariati Avenue, Tehran, Iran

    Nahid Shirazian

  2. Department of Obstetrics and Gynecology, Islamic Azad University, Tehran Medical Branch, Tehran, Iran

    Roya Emdadi, Marjan Mahboubi, Zhaleh Fazel-Sarjuei, Narges Sedighpour & Seyade-Fateme Fadaki

  3. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Abbas Motevallian

  4. Islamic Azad University, Tehran Medical Branch, Tehran, Iran

    Narges Shahmoradi

Authors
  1. Nahid Shirazian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roya Emdadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marjan Mahboubi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Abbas Motevallian
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zhaleh Fazel-Sarjuei
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Narges Sedighpour
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seyade-Fateme Fadaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Narges Shahmoradi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nahid Shirazian.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shirazian, N., Emdadi, R., Mahboubi, M. et al. Screening for gestational diabetes: usefulness of clinical risk factors. Arch Gynecol Obstet 280, 933–937 (2009). https://doi.org/10.1007/s00404-009-1027-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-009-1027-y

Keywords

Search

Navigation