Pregnant Women Should Be Screened for Gestational Diabetes.(Brief Article)

2001 SEP 13 - (NewsRx.com & NewsRx.net) -- In its new evidence-based recommendations on gestational diabetes mellitus (GDM), the American College of Obstetricians and Gynecologists (ACOG) advises that it is appropriate to screen all pregnant women for GDM, whether by patient history, clinical risk factors for GDM, or a laboratory test to determine blood glucose levels.

ACOG acknowledges, however, that more research is needed before it can be determined what screening method is best and when it should occur.

GDM, which affects approximately 100,000 American women each year, is carbohydrate intolerance first recognized during pregnancy. GDM can occur when the hormones produced by the placenta affect the way insulin works. In some cases, diabetes that existed before pregnancy may be harder to control. Risks to the woman and fetus that can result from GDM include preeclampsia or high blood pressure; urinary tract infections; and macrosomia, or a very large baby, which can make delivery difficult and may lead to cesarean birth. Risks to the newborn include birth defects affecting the heart, kidneys, and spine, as well as respiratory distress syndrome.

Clinical risk factors associated with GDM include age, ethnicity, obesity, family history of diabetes, and past obstetric history. According to ACOG, a woman is considered low risk for developing GDM, and thus may not need lab screening methods, if she meets all of the following criteria:

* less than 25 years old

* not a member of a racial or ethnic group with a high prevalence of diabetes (e.g., Hispanic, African, Native American, South or East Asian, or Pacific Islands ancestry)

* a body mass index