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Task Force Issues Screening Recommendation for Women With Gestational Diabetes

All women should be checked after 24 weeks of pregnancy (May 28)

The U.S. Preventive Services Task Force has posted a draft recommendation statement on screening women for diabetes developed during pregnancy (gestational diabetes).

The statement has two parts:

  • The task force recommends screening for gestational diabetes after 24 weeks of pregnancy in all women without symptoms of the condition.
  • The task force also found that the current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes earlier than 24 weeks of pregnancy.

“It’s important to remember that each case of gestational diabetes affects two people: the expectant mother and the baby,” said task force member Wanda K. Nicholson, MD, MPH, MBA. “We now have good evidence that screening expectant mothers for gestational diabetes after 24 weeks provides a substantial benefit, with few to no harms, leading to healthier moms and babies.”

Gestational diabetes is the persistent inability to process starches or sugars into energy in women who did not have diabetes before pregnancy. The condition usually resolves after birth but can put expectant mothers and their babies at risk for health problems.

Health problems for pregnant women with gestational diabetes include labor and birth complications, pre-eclampsia (a condition in pregnant women characterized by high blood pressure and high levels of protein in the urine that, if left untreated, may result in life-threatening seizures), and an increased likelihood of developing diabetes later in life. Infants and children may have overly large birth weight, birth injuries, glucose intolerance, and obesity in childhood.

About 240,000 of the approximately 4 million women who give birth each year, or about 7%, develop gestational diabetes. The condition is on the rise as obesity, older age during pregnancy, and other risk factors become more common among pregnant women, according to the task force.

Since 2008, when the task force last looked at the evidence on screening pregnant women for diabetes, data emerged showing that there is an overall benefit to screening expectant mothers, including lowering the risk of pre-eclampsia, giving birth to overly large babies (macrosomia), and birth emergencies caused by large infants becoming stuck in the birth canal (shoulder dystocia). While there isn’t enough evidence to support screening for gestational diabetes earlier than 24 weeks of pregnancy, future research may yield greater clarity on how to better diagnose and manage diabetes early in pregnancy, the task force says.

“It’s always better to prevent a disease than to be diagnosed with one,” Nicholson remarked. “Women should have a conversation with their doctor before getting pregnant or in the early stages of pregnancy about steps they can take — such as improving their diet, being physically active, or other strategies — to reduce their risk of developing gestational diabetes.”

Source: USPSTF; May 28, 2013.

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