Risk Factors For Gestational Diabetes Mellitus

1765 WordsFeb 11, 20158 Pages
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…
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 been diagnosed with GDM. Risk factors such as those used by Cosson, et al. (2013) are an important component of screening for gestational diabetes and should be considered an important tool in screening for GDM. However, it is reasonable to assume that not all risk factors are created equal. In this study, for example, a previous delivery of a macrosomic infant increased the risk of GDM 1.6- to 6.2-fold. Risk factors should be scored based on the observed impact they exert on the prevalence of GDM. Metzger , et al. (2007) recommended that a risk assessment for GDM be performed at the
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