USPSTF recommends gestational diabetes screening at or after 24 weeks
The U.S. Preventive Services Task Force said it recommends screening for gestational diabetes in asymptomatic women who have been pregnant for 24 weeks or more.
The evidence was insufficient to make a recommendation regarding asymptomatic women who have been pregnant fewer than 24 weeks, the task force said. The B grade and I grade recommendations mirror the 2014 USPSTF statement in this area and are based on a review of 76 studies.
The prevalence of gestational diabetes is estimated to be between 5.8% and 9.2% of U.S. women, according to the task force.
Other medical societies — including the American College of Obstetricians and Gynecologists, NIH, American Diabetes Association and Endocrine Society — encourage gestational diabetes screening between 24 and 28 weeks of gestation, although there is some variation among them regarding the screening strategy, according to the USPSTF. Despite this, data previously presented at the American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting indicate that many eligible pregnant women in the U.S. are not screened for gestational diabetes.
Michael Cabana, MD, MPH, a task force member and a professor of pediatrics at the Albert Einstein College of Medicine, told Healio Primary Care that gestational diabetes screening is “safe and effective,” and that it is “vital that clinicians actively work to overcome any barriers that stand in the way of helping keep patients and their babies healthy.”
Because there was not enough evidence to make a recommendation for women who are less than 24 weeks pregnant, clinicians need to use their judgement to determine when screening is warranted, Chien-Wen Tseng, MD, MPH, MSE, another task force member and research director in the department of family medicine and community health at the University of Hawaii John A. Burns School of Medicine, said in a press release.
The grade I recommendation should serve as a call to action for more research in this area, Cuilin Zhang, MD, MPH, PhD, principal investigator of diabetes and women’s health studies at NIH and Patrick Catalano, MD, vice chair of obstetrics and gynecology research and principal investigator at the Mother Infant Research Institute at Tufts Medical Center, wrote in a related editorial.
“This is particularly relevant and timely, given the accumulating evidence supporting the adverse influence of glycemia and possibly other nutrients on fetal growth in early pregnancy,” Zhang and Catalano wrote.