Review: Gestational DM Screening Recommended After 24 Weeks
(HealthDay News) – The U.S. Preventive Services Task Force (USPSTF) recommends use of the 50-g oral glucose challenge test (OGCT) for screening pregnant women for gestational diabetes mellitus (GDM) after 24 weeks of gestation. This Recommendation Statement is based on an evidence review published online May 28 in the Annals of Internal Medicine.
Lois Donovan, PhD, from the University of Calgary in Canada, and colleagues used data from 51 cohort studies to examine the screening methods for GDM.
The researchers found that, at a threshold of 7.8mmol/L, the sensitivity for the OGCT was 70–88%; specificity was 69–89%; positive likelihood ratio was 2.6–6.5; and negative likelihood ratio was 0.16–0.33. Test characteristics were 88–99%, 66–77%, 2.7–4.2, and 0.02–0.14, respectively, at a threshold of 7.2mmol/L. Poorer test characteristics were seen for glycated hemoglobin level vs. fasting plasma glucose or the OGCT. For screening tests before 24 gestational weeks, there were few data available. The draft Recommendation Statement is available for comment from May 28–June 24, 2013.
"It's important to remember that each case of gestational diabetes affects two people: the expectant mother and the baby," Task Force member Wanda K. Nicholson, MD, MPH, said in a statement. "We now have good evidence that screening expectant mothers for gestational diabetes after 24 weeks provides a substantial benefit, with few to no harms, leading to healthier moms and babies."