[Patterns physicians use to screen for gestational diabetes: descriptive analysis in a cohort of 701 women]

Abstract

Objective: To study the way physicians screen for gestational diabetes.

Patients and methods: Descriptive analysis of the pattern of screening used by physicians for 701 women who gave birth in a public or private maternity in the Rhône district in France.

Results: Overall, a screening test was used in 17.7% of the women (95%CI 14.9-20.7). A 50 g glucose tolerance test was performed in 60% of the screening prescriptions and was positive in 37.3%. One-third of the screening tests were achieved after the 28th gestational week. About half of the women were at risk for gestational diabetes. Among them, 24.6% had had a screening test. Factors associated with prescription of a screening test were gestational diabetes or macrosomia in a previous pregnancy, diabetes in relatives, high body mass index, weight gain of more than 15 kg, African origin, and follow-up in a public maternity. The diagnosis of gestational diabetes was made in 9 women. The prevalence of gestational diabetes was 1.28% (95%CI 0.59%-2.42%).

Conclusion: Guidelines from the national colleges of obstetricians and endocrinologists for systematic screening for gestational diabetes are not properly applied. Questions concerning the implementation, results, and feasibility of these guidelines are raised.