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Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects

OBJECTIVE: We aimed to evaluate a selective screening strategy for gestational diabetes mellitus (GDM) based on the presence of risk factors: BMI ≥25 kg/m(2), age ≥35 years, family history of diabetes, personal history of GDM, or birth of a child with macrosomia. RESEARCH DESIGN AND METHODS: Of 20,6...

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Autores principales: Cosson, Emmanuel, Benbara, Amélie, Pharisien, Isabelle, Nguyen, Minh Tuan, Revaux, Aurélie, Lormeau, Boris, Sandre-Banon, Dorian, Assad, Nabil, Pillegand, Camille, Valensi, Paul, Carbillon, Lionel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579341/
https://www.ncbi.nlm.nih.gov/pubmed/23150287
http://dx.doi.org/10.2337/dc12-1428
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author Cosson, Emmanuel
Benbara, Amélie
Pharisien, Isabelle
Nguyen, Minh Tuan
Revaux, Aurélie
Lormeau, Boris
Sandre-Banon, Dorian
Assad, Nabil
Pillegand, Camille
Valensi, Paul
Carbillon, Lionel
author_facet Cosson, Emmanuel
Benbara, Amélie
Pharisien, Isabelle
Nguyen, Minh Tuan
Revaux, Aurélie
Lormeau, Boris
Sandre-Banon, Dorian
Assad, Nabil
Pillegand, Camille
Valensi, Paul
Carbillon, Lionel
author_sort Cosson, Emmanuel
collection PubMed
description OBJECTIVE: We aimed to evaluate a selective screening strategy for gestational diabetes mellitus (GDM) based on the presence of risk factors: BMI ≥25 kg/m(2), age ≥35 years, family history of diabetes, personal history of GDM, or birth of a child with macrosomia. RESEARCH DESIGN AND METHODS: Of 20,630 deliveries between 2002 and 2010, we selected 18,775 deliveries in women with no known diabetes and for whom all risk factors were known. GDM was universally screened and defined as fasting plasma glucose level ≥5.3 mmol/L and/or 2-h postload (75 g) glucose level ≥7.8 mmol/L. RESULTS: The prevalence of at least one risk factor has increased since 2002 (P < 0.001) from 51.7 to 61.5%, with no change in the GDM prevalence (mean 14.4%, intention to screen). At least one risk factor was present in 58.5% of women who represented 65.3% of all those with GDM. The presence of risk factors was significantly associated with GDM (odds ratio 1.4 [95% CI 1.3–1.5], P < 0.001) and with GDM-related events (preeclampsia/large for gestational age/dystocia) (P < 0.001) with the following incidences: no GDM/no risk factor 8.8%, no GDM/risk factor 11.1%, GDM/no risk factor 16.7%, and GDM/risk factor 18.2%. CONCLUSIONS: The presence of risk factors increased during the last decade. This condition is predictive of GDM and GDM-related events. However, a selective screening would lead to missing one-third of the women with GDM who, even without risk factors, had more events than women without GDM. Therefore, these data stand against the present selective screening currently proposed in the French guidelines.
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spelling pubmed-35793412014-03-01 Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects Cosson, Emmanuel Benbara, Amélie Pharisien, Isabelle Nguyen, Minh Tuan Revaux, Aurélie Lormeau, Boris Sandre-Banon, Dorian Assad, Nabil Pillegand, Camille Valensi, Paul Carbillon, Lionel Diabetes Care Original Research OBJECTIVE: We aimed to evaluate a selective screening strategy for gestational diabetes mellitus (GDM) based on the presence of risk factors: BMI ≥25 kg/m(2), age ≥35 years, family history of diabetes, personal history of GDM, or birth of a child with macrosomia. RESEARCH DESIGN AND METHODS: Of 20,630 deliveries between 2002 and 2010, we selected 18,775 deliveries in women with no known diabetes and for whom all risk factors were known. GDM was universally screened and defined as fasting plasma glucose level ≥5.3 mmol/L and/or 2-h postload (75 g) glucose level ≥7.8 mmol/L. RESULTS: The prevalence of at least one risk factor has increased since 2002 (P < 0.001) from 51.7 to 61.5%, with no change in the GDM prevalence (mean 14.4%, intention to screen). At least one risk factor was present in 58.5% of women who represented 65.3% of all those with GDM. The presence of risk factors was significantly associated with GDM (odds ratio 1.4 [95% CI 1.3–1.5], P < 0.001) and with GDM-related events (preeclampsia/large for gestational age/dystocia) (P < 0.001) with the following incidences: no GDM/no risk factor 8.8%, no GDM/risk factor 11.1%, GDM/no risk factor 16.7%, and GDM/risk factor 18.2%. CONCLUSIONS: The presence of risk factors increased during the last decade. This condition is predictive of GDM and GDM-related events. However, a selective screening would lead to missing one-third of the women with GDM who, even without risk factors, had more events than women without GDM. Therefore, these data stand against the present selective screening currently proposed in the French guidelines. American Diabetes Association 2013-03 2013-02-13 /pmc/articles/PMC3579341/ /pubmed/23150287 http://dx.doi.org/10.2337/dc12-1428 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Cosson, Emmanuel
Benbara, Amélie
Pharisien, Isabelle
Nguyen, Minh Tuan
Revaux, Aurélie
Lormeau, Boris
Sandre-Banon, Dorian
Assad, Nabil
Pillegand, Camille
Valensi, Paul
Carbillon, Lionel
Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects
title Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects
title_full Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects
title_fullStr Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects
title_full_unstemmed Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects
title_short Diagnostic and Prognostic Performances Over 9 Years of a Selective Screening Strategy for Gestational Diabetes Mellitus in a Cohort of 18,775 Subjects
title_sort diagnostic and prognostic performances over 9 years of a selective screening strategy for gestational diabetes mellitus in a cohort of 18,775 subjects
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579341/
https://www.ncbi.nlm.nih.gov/pubmed/23150287
http://dx.doi.org/10.2337/dc12-1428
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