Publication:

Screening and diagnosis of gestational diabetes: a hybrid method

Background In Mexico the gestational diabetes prevalence varies between 4 and 13%. The main purpose of this study is to determine the prevalence of gestational diabetes, the relevance of its risk factors, and its repercussions in pregnancy with a hybrid diagnostic method.

Methods This prospective, longitudinal, and observational study includes 347 pregnant women. Screening for gestational diabetes was performed with the O’Sullivan test, with a cut-off point of 140 mg/dL of glucose, followed by a 75-gram oral glucose tolerance test in patients with an abnormal screening test. The diagnosis was made with one or more abnormal results. Different variables were evaluated in these patients; from risk factors, to complications of gestational diabetes.

Results Of the 347 patients studied, 77 (22.2%) had a positive screen and 34 patients were confirmed with gestational diabetes (9.8%). A body mass index greater than or equal to 25 increased the relative risk by 2.52, the history of macrosomia by 4.10, a maternal age greater than or equal to 36 years by 2.54, and the presence of a twin pregnancy by 6.94. Regarding complications, there was an increase in prevalence of macrosomia (RR=4.09).

Conclusions The prevalence of gestational diabetes, using the combination of the two existing classical methods, is similar to that reported in other national and international studies, while also avoiding overdiagnosis, over-monitoring, and reducing typical discomforts that may come by using the one-step method.