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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8003050 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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