Universal versus selective screening for detection of gestational diabetes mellitus in a Malaysian population
Objectives: To compare the efficacy of two screenings methods for gestational diabetes mellitus, namely the universalscreening using 50g Glucose Challenge Test to that of selective screening based on risk factors.
Methodology: A cross-sectional study involving 366 women between 24 weeks to 28 weeks gestation who attended acommunity health clinic for their antenatal care between January to May 2003. All women had their risk factors forgestational diabetes identified at the beginning of the study, after which they underwent a 50g Glucose Challenge Testand subsequently the 75g Oral Glucose Tolerance Test.
Results: The prevalence of gestational diabetes mellitus in this population was 18.3%. The universal screening had asensitivity of 83.5% and specificity of 82.6% compared to that of selective screening, 76.1% and 60.9% respectively.Of all patients diagnosed to have gestational diabetes mellitus, 23.8% were without risk factors.
Conclusion: Universal screening strategy using 50g glucose challenge test is a better predictor of gestational diabetesmellitus compared to risk-based selective screening.
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