Options for screening for gestational diabetes mellitus during the SARS-CoV-2 pandemic
Date
2020
Authors
Simmons, D.
Rudland, V.L.
Wong, V.
Flack, J.
Mackie, A.
Ross, G.P.
Coat, S.
Dalal, R.
Hague, B.M.
Cheung, N.W.
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Journal article
Citation
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020; 60(5):660-666
Statement of Responsibility
David Simmons, Victoria L. Rudland, Vincent Wong, Jeff Flack, Adam Mackie, Glynis P. Ross, Suzette Coat, Raiyomand Dalal, Bill M. Hague, and Ngai Wah Cheung
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Abstract
The balance between avoiding severe acute respiratory syndrome coronavirus-2 contagion and reducing wider clinical risk is unclear for gestational diabetes mellitus (GDM) testing. Recent recommendations promote diagnostic approaches that limit collection but increase undiagnosed GDM, which potentially increases adverse pregnancy outcome risks. The most sensitive approach to detecting GDM at 24–28 weeks beyond the two-hour oral glucose tolerance test (OGTT) is a onehour OGTT (88% sensitivity). Less sensitive approaches use fasting glucose alone (≥5.1 mmol/L: misses 44–54% GDM) or asking ~20% of women for a second visit (fasting glucose 4.7–5.0 mmol/L (62–72% sensitive)). Choices should emphasise local and patient decision-making.
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© 2020 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists