Prevalence of Gestational Diabetes According to One-Step and Two-Step Screening in Sari Rural Areas, 2012-2014

Abstract

Background and purpose: All pregnant women should be screened for diabetes mellitus. In this regard, two strategies are proposed that superiority of these two is still not clear. The aim of this study was to investigate the prevalence of gestational diabetes mellitus (GDM) according to these recommended strategies, (one-step and two-step glucose tolerance tests) in pregnant women attending health centers in rural areas of Sari, Iran during 2012-2014. Materials and methods: In this cross-sectional study, the medical records of pregnant women were randomly selected using cluster sampling. In Sari rural areas, the gestational diabetes mellitus screening had been done by two-step (50-g and 100-g) and one- step (75-g) tests in 2012 and 2014, respectively. Demographic data and the results of the glucose tolerance tests were extracted from the records and the frequency and odds ratios were calculated with a confidence interval of 95%. Results: Totally, 627 subjects (one-step n= 317 and two-step n=310 patients) were investigated. The mean ages in those screened by one-step and two-step tests were 26.6±4.1 and 26.5±4 years, respectively (P= 0.843). The mean values for BMI, history of pervious gestational diabetes and macrosomal baby delivery and diabetes familial history were not significantly different between the two groups. According to one-step screening, the prevalence of GDM was 38.5% (CI95%:33.1-44.1) while, the two-step test showed a prevalence rate of 4.2% (CI95%:2.3-7.1) (P< 0.0001) OR=14.3 (CI95%: 7.8-26.0). Conclusion: Prevalence of gestational diabetes mellitus is estimated to be much higher in one-step compared with that of the two-step screening. But, maternal and fetal benefits of this method should be assessed more accurately.

Keywords

• gestational diabetes
• screening
• 75g test
• 100g test
• one-step
• two-step