GESTATIONAL DIABETES MELLITUS IN LOW-RISK POPULATIONS: TO SCREEN OR NOT TO SCREEN?

Abstract

Background: Gestational Diabetes Mellitus (GDM) is characterized by glucose intolerance first recognized during pregnancy, posing significant health risks to both mother and fetus. The prevalence of GDM varies globally, influenced by ethnicity, diagnostic criteria, and population characteristics. Despite extensive research, the optimal strategy for GDM screening remains debated, especially in low-risk populations. Objectives:  This study aims to evaluate the prevalence of GDM in low-risk pregnant women in the Mekong Delta and determine whether routine screening in this population is justified. Materials and methods:  A cross-sectional study was conducted from June 2017 to June 2022 in four maternity hospitals in the Mekong Delta. Pregnant women with a gestational age between 24 and 28 weeks, based on the first trimester ultrasound or last menstrual period, were included. The 75g Oral Glucose Tolerance Test (OGTT) was performed according to the American Diabetes Association (ADA) 2018 standards. Demographic, clinical characteristics, and plasma glucose levels were compared between low-risk and higher-risk groups. Results: The study included 347 low-risk and 1380 higher-risk pregnant women. The prevalence of GDM was significantly lower in the low-risk group (9.5%) compared to the higher-risk group (19.1%, p < 0.001). Plasma glucose levels were significantly lower in the low-risk group across all measures (FPG, 1-hour PG, and 2-hour PG). Conclusion:  The rate of GDM in the low-risk group is about half that of the higher-risk group; however, it is still approximately ten percent. Therefore, universal screening for all individuals is necessary, but more optimal strategies for each group are needed in the future to both avoid missing cases and ensure economic efficiency.