Impact of selective screening for gestational diabetes in a Spanish population

BACKGROUND: Recently, the American Diabetes Association (ADA) concluded tha t pregnant women with low risk factors far gestational diabetes need not to be tested. The aims of this study was to determine the prevalence of gesta tional diabetes in a Spanish low risk pregnant women population, to analyze the criteria that define low risk pregnancies for gestational diabetes, an d to compare the differences in morbidity between pregnant women with and w ithout gestational diabetes. DESIGN AND METHODS: cohort study of 2,262 gestations (2,085 Caucasians) dur ing a period of 7 years in a reference hospital. RESULTS: The gestational diabetes prevalence was 15%. Two-hundred and seven ty-four (12.1%) women were considered as a low risk group for gestational d iabetes. Among these, 13 (4.7%) presented gestational diabetes in compariso n with 16.6% in the remaining women (p = 0.0001). Gestational diabetes in t he low risk pregnant women constituted the 3.8% of all gestational diabetes . We did not find differences in gestational outcomes or fetal antropometry between the groups, The relative risk of macrosomia in the low risk pregna nt was 0.9% (95% confidence interval for the mean: 0.86-0.94). CONCLUSIONS: In spite of their capacity of identifying current complication s, 4% of gestational diabetes would not have been diagnosed with the new AD A criteria. The misdiagnosis will prevent in this small group of women the adoption of preventive measures for subsequent pregnancies and for diabetes in later life.