Risk Factors For Gestational Diabetes Mellitus

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While a universal screening strategy is the best strategy to assure that all women with GDM are diagnosed and treated, the cost of such a strategy may prove to be prohibitive for some populations. Known risk factors for gestational diabetes mellitus include a family history of diabetes, race (Asian, African-American, Hispanic and Native American women have a higher incidence of GDM than non-Hispanic Caucasian women [Ferrara, 2007; Slocum and Burke Sosa, 2002]), obesity (body mass index [BMI] ≥25 kg/m2), high pre-pregnancy fasting blood glucose levels, increased maternal age, parity, polycystic ovarian syndrome, sociodemographic and behavioral attributes, previous adverse pregnancy outcomes, and previous GDM (Gunderson, et al., 2007;…show more content…
The risk factors selected for this study were a family history of diabetes, a personal history of GDM, maternal age of 35 or older, a BMI ≥25 kg/m2, and a history of macrosomia in a previous pregnancy. It should be noted that two of these criteria (previous GDM and previous macrosomic infant) cannot be applied to nulliparous women. In this study, investigators found that the number of risk factors identified was directly proportional to the prevalence of GDM and the incidence of adverse events related to GDM, including preeclampsia, macrosomia, LGA infants, and shoulder dystocia. Interestingly, 35% of the women on the study that did not have any of the risk factors identified were subsequently diagnosed with gestational diabetes. These women also experienced more GDM-related events, despite being treated, than women without GDM. This high percentage is likely reflective of the low number of risk factors used in the study (only three risk factors for nulliparous women), combined with the fact that patients may be mistaken regarding family medical history. The patients in this study were predominantly of low socioeconomic status, which is considered by many experts to be a risk factor for GDM (Gunderson, et al., 2007). If socioeconomic status had been used as one of the risk factors evaluated, it is likely that far fewer than 35% of patients without risk factors would have
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