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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-12

AUTHORS

Yap-Seng Chong, Shirong Cai, Harvard Lin, Shu E Soh, Yung-Seng Lee, Melvin Khee-Shing Leow, Yiong-Huak Chan, Li Chen, Joanna D Holbrook, Kok-Hian Tan, Victor Samuel Rajadurai, George Seow-Heong Yeo, Michael S Kramer, Seang-Mei Saw, Peter D Gluckman, Keith M Godfrey, Kenneth Kwek

ABSTRACT

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. More... »

PAGES

345

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1471-2393-14-345

DOI

http://dx.doi.org/10.1186/1471-2393-14-345

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1041558032

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25273851


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445 Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, 119228, Singapore, Singapore
446 the GUSTO study group, UK
447 rdf:type schema:Organization
448 https://www.grid.ac/institutes/grid.9654.e schema:alternateName University of Auckland
449 schema:name Agency for Science and Technology Research (A*STAR), Brenner Center for Molecular Medicine, Singapore Institute for Clinical Sciences, 30 Medical Drive, 117609, Singapore, Singapore
450 Liggins Institute, University of Auckland, 1142, Auckland, New Zealand
451 rdf:type schema:Organization
 




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