Early diagnosis of gestational diabetes mellitus and prevention of diabetes-related complications

Objective: To test the hypothesis that an early diagnosis of gestational diabetes mellitus (GDM) could avoid some diabetes-related complications. Study design: We compared the rates of pregnancy complications commonly related to diabetes between 189 (later screening group) and 235 (earlier screening group) women with GDM diagnosed before and after adding an universal glucose tolerance screening performed in the first antenatal visit to the traditional screening performed at 24-28 weeks of gestation. Results: Women in the later screening group were likely to have hydramnios (12.7 versus 2.1%, P < 0.0001) and preterm deliveries (11.8 versus 5.5%; P = 0.03). All cases of preterm premature rupture of membranes and fetal anomalies took place in the later screening group (P = 0.03, P = 0.007, respectively). Statistical analysis was performed using the Student's t-test, Mann-Whitney's U-test, Fisher's exact test and x(2)-test. Statistical significance was set at 95% level (P < 0.05). Conclusions: Early glucose tolerance screening could avoid some diabetes-related complications in women with gestational diabetes. However, further studies are needed to know if it should be done in all pregnant women or only in those with a high risk of developing diabetes. (C) 2002 Published by Elsevier Science Ireland Ltd.