Universal versus selective screening for detection of gestational diabetes mellitus in a malaysian population.

OBJECTIVES To compare the efficacy of two screenings methods for gestational diabetes mellitus, namely the universal screening using 50g Glucose Challenge Test to that of selective screening based on risk factors. METHODOLOGY A cross-sectional study involving 366 women between 24 weeks to 28 weeks gestation who attended a community health clinic for their antenatal care between January to May 2003. All women had their risk factors for gestational diabetes identified at the beginning of the study, after which they underwent a 50g Glucose Challenge Test and subsequently the 75g Oral Glucose Tolerance Test. RESULTS The prevalence of gestational diabetes mellitus in this population was 18.3%. The universal screening had a sensitivity of 83.5% and specificity of 82.6% compared to that of selective screening, 76.1% and 60.9% respectively. Of all patients diagnosed to have gestational diabetes mellitus, 23.8% were without risk factors. CONCLUSION Universal screening strategy using 50g glucose challenge test is a better predictor of gestational diabetes mellitus compared to risk-based selective screening.