Selective or universal diagnostic testing for gestational diabetes mellitus

Objectives: To estimate the effect of selective diagnostic testing for gestational diabetes mellitus (GDM): (1) based on evaluation of risk factors; and (2) based on the recommendations of The Fourth Workshop-Conference on GDM. Methods: A retrospective study was performed of 147 pregnancies complicated by GDM delivered in Kaunas University of Medicine Hospital. The maternal and fetal outcomes and the main risk factors were compared with the same data of a randomly selected 300 women with normal glucose tolerance testing. Logistic regression was used to estimate the odds ratios with 95% confidence interval (CI). Results: The prevalence of all risk factors was significantly higher in the group with GDM, but 29 of these women (23.13%) had no risk factors. Sixteen women (10.9%) with GDM were at low risk and would remain undiagnosed if selective screening would be used. Conclusions: The recommendations not to test low-risk group women are doubtful and require further examination whereas universal screening of all pregnant women would be justified. (C) 2002 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved.