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Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: a cohort study.

Publication ,  Journal Article
Chong, Y-S; Cai, S; Lin, H; Soh, SE; Lee, Y-S; Leow, MK-S; Chan, Y-H; Chen, L; Holbrook, JD; Tan, K-H; Rajadurai, VS; Yeo, GS-H; Kramer, MS ...
Published in: BMC Pregnancy Childbirth
October 2, 2014

BACKGROUND: Universal and high-risk screening for gestational diabetes mellitus (GDM) has been widely studied and debated. Few studies have assessed GDM screening in Asian populations and even fewer have compared Asian ethnic groups in a single multi-ethnic population. METHODS: 1136 pregnant women (56.7% Chinese, 25.5% Malay and 17.8% Indian) from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study were screened for GDM by 75-g oral glucose tolerance test (OGTT) at 26-28 weeks of gestation. GDM was defined using the World Health Organization (WHO) criteria. High-risk screening is based on the guidelines of the UK National Institute for Health and Clinical Excellence. RESULTS: Universal screening detected significantly more cases than high-risk screening [crude OR 2.2 (95% CI 1.7-2.8)], particularly for Chinese women [crude OR = 3.5 (95% CI 2.5-5.0)]. Pre-pregnancy BMI > 30 kg/m2 (adjusted OR = 3.4, 95% CI 1.5-7.9) and previous GDM history (adjusted OR = 6.6, 95% CI 1.2-37.3) were associated with increased risk of GDM in Malay women while GDM history was the only significant risk factor for GDM in Chinese women (adjusted OR = 4.7, 95% CI 2.0-11.0). CONCLUSION: Risk factors used in high-risk screening do not sufficiently predict GDM risk and failed to detect half the GDM cases in Asian women. Asian women, particularly Chinese, should be screened to avoid under-diagnosis of GDM and thereby optimize maternal and fetal outcomes.

Duke Scholars

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Published In

BMC Pregnancy Childbirth

DOI

EISSN

1471-2393

Publication Date

October 2, 2014

Volume

14

Start / End Page

345

Location

England

Related Subject Headings

  • Young Adult
  • Singapore
  • Sensitivity and Specificity
  • Risk Factors
  • Reproductive History
  • Prevalence
  • Pregnancy
  • Practice Guidelines as Topic
  • Obstetrics & Reproductive Medicine
  • Mass Screening
 

Citation

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Chong, Y.-S., Cai, S., Lin, H., Soh, S. E., Lee, Y.-S., Leow, M.-S., … GUSTO study group, . (2014). Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: a cohort study. BMC Pregnancy Childbirth, 14, 345. https://doi.org/10.1186/1471-2393-14-345
Chong, Yap-Seng, Shirong Cai, Harvard Lin, Shu E. Soh, Yung-Seng Lee, Melvin Khee-Shing Leow, Yiong-Huak Chan, et al. “Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: a cohort study.BMC Pregnancy Childbirth 14 (October 2, 2014): 345. https://doi.org/10.1186/1471-2393-14-345.
Chong Y-S, Cai S, Lin H, Soh SE, Lee Y-S, Leow MK-S, et al. Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: a cohort study. BMC Pregnancy Childbirth. 2014 Oct 2;14:345.
Chong, Yap-Seng, et al. “Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: a cohort study.BMC Pregnancy Childbirth, vol. 14, Oct. 2014, p. 345. Pubmed, doi:10.1186/1471-2393-14-345.
Chong Y-S, Cai S, Lin H, Soh SE, Lee Y-S, Leow MK-S, Chan Y-H, Chen L, Holbrook JD, Tan K-H, Rajadurai VS, Yeo GS-H, Kramer MS, Saw S-M, Gluckman PD, Godfrey KM, Kwek K, GUSTO study group. Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: a cohort study. BMC Pregnancy Childbirth. 2014 Oct 2;14:345.
Journal cover image

Published In

BMC Pregnancy Childbirth

DOI

EISSN

1471-2393

Publication Date

October 2, 2014

Volume

14

Start / End Page

345

Location

England

Related Subject Headings

  • Young Adult
  • Singapore
  • Sensitivity and Specificity
  • Risk Factors
  • Reproductive History
  • Prevalence
  • Pregnancy
  • Practice Guidelines as Topic
  • Obstetrics & Reproductive Medicine
  • Mass Screening