Adherence rates to a prediction tool identifying women with an increased gestational diabetes risk: An implementation study. Issue 1 (5th January 2021)

• Record Type: Journal Article
• Authors: van Montfort, Pim; Scheepers, Hubertina C. J.; van Dooren, Ivo M. A.; Meertens, Linda J. E.; Wynants, Laure; Zelis, Maartje; Zwaan, Iris M.; Spaanderman, Marc E. A.; Smits, Luc J. M.
• Is Part Of: International journal of gynaecology and obstetrics. Volume 154:Issue 1(2021)
• Page Start: 85
• Page End: 91
• Publication Date: 2021-01-05
• Subjects: gestational diabetes mellitus -- oral glucose tolerance test -- prediction -- pregnancy -- screening; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.13517
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: The best screening strategy for gestational diabetes mellitus (GDM) remains a topic of debate. Several organizations made a statement in favor of universal screening, but the volume of oral glucose tolerance tests (OGTT) required may burden healthcare systems. As a result, many countries still rely on selective screening using a checklist of risk factors, but reported diagnostic characteristics vary. Moreover, women's discomfort due to an OGTT is often neglected. Since 2017, obstetric healthcare professionals in a Dutch region assessed women's GDM risk with a prediction model and counseled those with an increased risk regarding an OGTT. Methods: From 2017 to 2018, 865 women were recruited in a multicenter prospective cohort. Results: In total, 385 women (48%) had an increased predicted GDM risk. Of all women, 78% reported that their healthcare professional discussed their GDM risk. Predicted GDM risks were positively correlated with conducting an OGTT. Conclusion: Implementation of a GDM prediction model resulted in moderate rates of OGTTs performed in general, but high rates in high‐risk women. As 25% of women experienced discomfort from the OGTT, a selective screening strategy based on a prediction model with a high detection rate may be an interesting alternative to universal screening. Study cohort registration: Netherlands Trial Register: NTR4143; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4143 . Synopsis: Implementing a gestational diabetes mellitus prediction model resulted in a majority of high‐risk women receiving an oral glucose tolerance test within the recommended gestational window.