Conflict of interest The authors have stated explicitly that there are no conflicts of interest in connection with this article.
MAIN RESEARCH ARTICLE
Timing of screening for gestational diabetes mellitus in women with moderate and severe obesity
Article first published online: 20 MAR 2012
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology
Acta Obstetricia et Gynecologica Scandinavica
Volume 91, Issue 4, pages 447–451, April 2012
How to Cite
O’DWYER, V., FARAH, N., HOGAN, J., O’CONNOR, N., KENNELLY, M. M. and TURNER, M. J. (2012), Timing of screening for gestational diabetes mellitus in women with moderate and severe obesity. Acta Obstetricia et Gynecologica Scandinavica, 91: 447–451. doi: 10.1111/j.1600-0412.2011.01324.x
Please cite this article as: O'Dwyer V, Farah N, Hogan J, O'Connor N, Kennelly MM, Turner MJ. Timing of screening for gestational diabetes mellitus in women with moderate and severe obesity. Acta Obstet Gynecol Scand 2012; 91:447–451.
- Issue published online: 20 MAR 2012
- Article first published online: 20 MAR 2012
- Accepted manuscript online: 15 NOV 2011 11:03PM EST
- Received: 23 June 2011, Accepted: 8 November 2011
- Gestational diabetes mellitus;
- glucose tolerance test;
- maternal obesity;
- antenatal screening
Objective. We evaluated screening with a diagnostic oral glucose tolerance test earlier than 20 weeks gestation in women with moderate to severe obesity. Design. Prospective observational study. Setting. Large university teaching hospital. Population. We enrolled 100 women booking for antenatal care in the first trimester at their convenience. Methods. Height and weight were measured and body mass index calculated. Only women with a body mass index>34.9 kg/m2 were included. Women were booked for a 100 g oral glucose tolerance test before 20 weeks and, if normal, another test at 28 weeks gestation. Main outcome measures. Impaired glucose tolerance and gestational diabetes mellitus. Results. Of the 100 women given an appointment for an oral glucose tolerance test before 20 weeks gestation, 92 attended. Of these, 10 (10.8%) women had an abnormal result, with impaired glucose tolerance in five (5.4%) cases and gestational diabetes mellitus in five (5.4%) cases. Of those with a normal result at 20 weeks, 81 attended for a repeat test at 28 weeks gestation. A further four (4.9%) had impaired glucose tolerance and four (4.9%) had gestational diabetes mellitus. A total of 18 (20.5%) of the 88 women who complied with screening had an abnormal test. Conclusions. Women who have moderate/severe obesity have a one in five chance of having an abnormal diagnostic oral glucose tolerance test when screened for gestational diabetes mellitus. To optimize maternal glycemic control in pregnancy, we suggest that women with a body mass index>34.9 kg/m2 may need to be screened early in pregnancy and, if the test is normal, again at 28 weeks gestation.