Screening for Gestational Diabetes: US Preventive Services Task Force Recommendation Statement

• Published in: JAMA : the journal of the American Medical Association 2021-08, Vol.326 (6), p.531-538
• Main Authors: Davidson, Karina W, Barry, Michael J, Mangione, Carol M, Cabana, Michael, Caughey, Aaron B, Davis, Esa M, Donahue, Katrina E, Doubeni, Chyke A, Kubik, Martha, Li, Li, Ogedegbe, Gbenga, Pbert, Lori, Silverstein, Michael, Stevermer, James, Tseng, Chien-Wen, Wong, John B
• Format: Article
• Language: English
• Subjects: Asymptomatic; Complications; Criteria; Diabetes mellitus (insulin dependent); Diabetes mellitus (non-insulin dependent); Fetuses; Gestation; Gestational diabetes; Health risks; Hypoglycemia; Neonates; Offspring; Pre-eclampsia; Preeclampsia; Pregnancy; Screening; Systematic review
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.2021.11922

IMPORTANCE: Gestational diabetes is diabetes that develops during pregnancy. Prevalence of gestational diabetes in the US has been estimated at 5.8% to 9.2%, based on traditional diagnostic criteria, although it may be higher if more inclusive criteria are used. Pregnant persons with gestational diabetes are at increased risk for maternal and fetal complications, including preeclampsia, fetal macrosomia (which can cause shoulder dystocia and birth injury), and neonatal hypoglycemia. Gestational diabetes has also been associated with an increased risk of several long-term health outcomes in pregnant persons and intermediate outcomes in their offspring. OBJECTIVE: The USPSTF commissioned a systematic review to evaluate the accuracy, benefits, and harms of screening for gestational diabetes and the benefits and harms of treatment for the pregnant person and infant. POPULATION: Pregnant persons who have not been previously diagnosed with type 1 or type 2 diabetes. EVIDENCE ASSESSMENT: The USPSTF concludes with moderate certainty that there is a moderate net benefit to screening for gestational diabetes at 24 weeks of gestation or after to improve maternal and fetal outcomes. The USPSTF concludes that the evidence on screening for gestational diabetes before 24 weeks of gestation is insufficient, and the balance of benefits and harms of screening cannot be determined. RECOMMENDATION: The USPSTF recommends screening for gestational diabetes in asymptomatic pregnant persons at 24 weeks of gestation or after. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes in asymptomatic pregnant persons before 24 weeks of gestation. (I statement)