Preference of Women for Gestational Diabetes Screening Method According to Tolerance of Tests and Population Characteristics.

Autor:	Raets L; Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium., Vandewinkel M; Medicine, KU Leuven, Leuven, Belgium., Van Crombrugge P; Department of Endocrinology, OLV ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium., Moyson C; Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium., Verhaeghe J; Department of Obstetrics & Gynecology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium., Vandeginste S; Department of Obstetrics & Gynecology, OLV ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium., Verlaenen H; Department of Obstetrics & Gynecology, OLV ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium., Vercammen C; Department of Endocrinology, Imelda ziekenhuis, Bonheiden, Belgium., Maes T; Department of Endocrinology, Imelda ziekenhuis, Bonheiden, Belgium., Dufraimont E; Department of Obstetrics & Gynecology, Imelda ziekenhuis, Bonheiden, Belgium., Roggen N; Department of Obstetrics & Gynecology, Imelda ziekenhuis, Bonheiden, Belgium., De Block C; Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital, Edegem, Belgium., Jacquemyn Y; Department of Obstetrics & Gynecology, Antwerp University Hospital, Edegem, Belgium., Mekahli F; Department of Endocrinology, Kliniek St-Jan Brussel, Brussel, Belgium., De Clippel K; Department of Obstetrics & Gynecology, Kliniek St-Jan Brussel, Brussel, Belgium., Van Den Bruel A; Department of Endocrinology, AZ St Jan Brugge, Brugge, Belgium., Loccufier A; Department of Obstetrics & Gynecology, AZ St Jan Brugge, Brugge, Belgium., Laenen A; Center of Biostatics and Statistical bioinformatics, KU Leuven, Leuven, Belgium., Devlieger R; Department of Obstetrics & Gynecology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium., Mathieu C; Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium., Benhalima K; Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium.
Jazyk:	angličtina
Zdroj:	Frontiers in endocrinology [Front Endocrinol (Lausanne)] 2021 Nov 08; Vol. 12, pp. 781384. Date of Electronic Publication: 2021 Nov 08 (Print Publication: 2021).
DOI:	10.3389/fendo.2021.781384
Abstrakt:	Aims: To determine the preferred method of screening for gestational diabetes mellitus (GDM). Methods: 1804 women from a prospective study (NCT02036619) received a glucose challenge test (GCT) and 75g oral glucose tolerance test (OGTT) between 24-28 weeks. Tolerance of screening tests and preference for screening strategy (two-step screening strategy with GCT compared to one-step screening strategy with OGTT) were evaluated by a self-designed questionnaire at the time of the GCT and OGTT. Results: Compared to women who preferred one-step screening [26.2% (472)], women who preferred two-step screening [46.3% (834)] were less often from a minor ethnic background [6.0% (50) vs . 10.7% (50), p=0.003], had less often a previous history of GDM [7.3% (29) vs . 13.8% (32), p=0.008], were less often overweight or obese [respectively 23.1% (50) vs . 24.8% (116), p<0.001 and 7.9% (66) vs . 18.2% (85), p<0.001], were less insulin resistant in early pregnancy (HOMA-IR 8.9 (6.4-12.3) vs . 9.9 (7.2-14.2), p<0.001], and pregnancy outcomes were similar except for fewer labor inductions and emergency cesarean sections [respectively 26.6% (198) vs . 32.5% (137), p=0.031 and 8.2% (68) vs . 13.0% (61), p=0.005]. Women who preferred two-step screening had more often complaints of the OGTT compared to women who preferred one-step screening [50.4% (420) vs . 40.3% (190), p<0.001]. Conclusions: A two-step GDM screening involving a GCT and subsequent OGTT is the preferred GDM screening strategy. Women with a more adverse metabolic profile preferred one-step screening with OGTT while women preferring two-step screening had a better metabolic profile and more discomfort of the OGTT. The preference for the GDM screening method is in line with the recommended Flemish modified two-step screening method, in which women at higher risk for GDM are recommended a one-step screening strategy with an OGTT, while women without these risk factors, are offered a two-step screening strategy with GCT. Clinical Trial Registration: NCT02036619 https://clinicaltrials.gov/ct2/show/NCT02036619. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Raets, Vandewinkel, Van Crombrugge, Moyson, Verhaeghe, Vandeginste, Verlaenen, Vercammen, Maes, Dufraimont, Roggen, De Block, Jacquemyn, Mekahli, De Clippel, Van Den Bruel, Loccufier, Laenen, Devlieger, Mathieu and Benhalima.)
Databáze:	MEDLINE
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