Selective versus Universal Screening for Gestational Diabetes Mellitus: An Evaluation of Naylor's Model

Aim: Selective screening for gestational diabetes is still a subject of debate. The aim of this study was to determine the effectiveness of a selective screening strategy for diagnosing gestational diabetes in our setting. This strategy rests on a scoring system that assigns women to different risk categories according to the presence of risk factors such as overweight, older age and ethnicity. Methods: We compared the rate of diagnosed gestational diabetes according to universal screening and selective screening between two periods of time. Results: The selective screening strategy allowed only 15% of women to avoid screening and was associated with a 50% decrease in diagnosed gestational diabetes. Conclusion: The two-threshold approach did not detect similar proportions of women with gestational diabetes compared with universal screening. Half the cases were missed and most women still needed to be screened. Copyright (C) 2009 S. Karger AG, Basel