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Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?

The incidence of gestational diabetes mellitus (GDM) is increasing worldwide. This has a significant effect on the health of the mother and offspring. There is no doubt that screening for GDM between 24 and 28 weeks is important to reduce the risk of adverse pregnancy outcomes. However, there is no...

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Detalles Bibliográficos
Autores principales: Raets, Lore, Beunen, Kaat, Benhalima, Katrien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003050/
https://www.ncbi.nlm.nih.gov/pubmed/33803650
http://dx.doi.org/10.3390/jcm10061257
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author Raets, Lore
Beunen, Kaat
Benhalima, Katrien
author_facet Raets, Lore
Beunen, Kaat
Benhalima, Katrien
author_sort Raets, Lore
collection PubMed
description The incidence of gestational diabetes mellitus (GDM) is increasing worldwide. This has a significant effect on the health of the mother and offspring. There is no doubt that screening for GDM between 24 and 28 weeks is important to reduce the risk of adverse pregnancy outcomes. However, there is no consensus about diagnosis and treatment of GDM in early pregnancy. In this narrative review on the current evidence on screening for GDM in early pregnancy, we included 37 cohort studies and eight randomized controlled trials (RCTs). Observational studies have shown that a high proportion (15–70%) of women with GDM can be detected early in pregnancy depending on the setting, criteria used and screening strategy. Data from observational studies on the potential benefit of screening and treatment of GDM in early pregnancy show conflicting results. In addition, there is substantial heterogeneity in age and BMI across the different study populations. Smaller RCTs could not show benefit but several large RCTs are ongoing. RCTs are also necessary to determine the appropriate cut-off for HbA1c in pregnancy as there is limited evidence showing that an HbA1c ≥6.5% has a low sensitivity to detect overt diabetes in early pregnancy.
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spelling pubmed-80030502021-03-28 Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence? Raets, Lore Beunen, Kaat Benhalima, Katrien J Clin Med Review The incidence of gestational diabetes mellitus (GDM) is increasing worldwide. This has a significant effect on the health of the mother and offspring. There is no doubt that screening for GDM between 24 and 28 weeks is important to reduce the risk of adverse pregnancy outcomes. However, there is no consensus about diagnosis and treatment of GDM in early pregnancy. In this narrative review on the current evidence on screening for GDM in early pregnancy, we included 37 cohort studies and eight randomized controlled trials (RCTs). Observational studies have shown that a high proportion (15–70%) of women with GDM can be detected early in pregnancy depending on the setting, criteria used and screening strategy. Data from observational studies on the potential benefit of screening and treatment of GDM in early pregnancy show conflicting results. In addition, there is substantial heterogeneity in age and BMI across the different study populations. Smaller RCTs could not show benefit but several large RCTs are ongoing. RCTs are also necessary to determine the appropriate cut-off for HbA1c in pregnancy as there is limited evidence showing that an HbA1c ≥6.5% has a low sensitivity to detect overt diabetes in early pregnancy. MDPI 2021-03-18 /pmc/articles/PMC8003050/ /pubmed/33803650 http://dx.doi.org/10.3390/jcm10061257 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Raets, Lore
Beunen, Kaat
Benhalima, Katrien
Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?
title Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?
title_full Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?
title_fullStr Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?
title_full_unstemmed Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?
title_short Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?
title_sort screening for gestational diabetes mellitus in early pregnancy: what is the evidence?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003050/
https://www.ncbi.nlm.nih.gov/pubmed/33803650
http://dx.doi.org/10.3390/jcm10061257
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