Gestational diabetes mellitus screening in pandemic times: Are there viable alternatives?

• Published in: Australian & New Zealand journal of obstetrics & gynaecology 2020-10, Vol.60 (5), p.E14-E15
• Main Authors: Rocha, Alexandre da Silva, Bernardi, Juliana Rombaldi, Matos, Salete, Kretzer, Daniela Cortés, Schöffel, Alice Carvalhal, Moretti, Felipe, Azevedo Magalhães, José Antônio
• Format: Article
• Language: English
• Subjects: Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Female; Glucose Tolerance Test; Humans; Letter to the Editor; Letters to the Editor; Mass Screening; Pandemics; Pregnancy
• ISSN: 0004-8666; 1479-828X
• DOI: 10.1111/ajo.13235

[...]the alternative recommendation for GDM screening during pregnancy involves demographic characteristics combined with haemoglobin A1c (HbA1c) or non‐fasting random plasma glucose for all pregnant women without pre‐existing diabetes. [...]while HbA1c above the 5.7% threshold is related to high specificity, it has low diagnostic sensitivity of approximately 25% as a GDM predictor.1 The ultrasound measurement of maternal visceral adipose tissue (m‐VAT) has been shown as a useful indicator of GDM among pregnant women, emerging as a marker of metabolic risk with greater accuracy than pre‐pregnancy body mass index (BMI) compatible with obesity that reaches maximum sensitivity ranging from 20%4 to 56%.5 m‐VAT can also be easily implemented during a routine ultrasound with no additional cost and fast learning curve among sonologists and sonographers. First‐trimester maternal abdominal adiposity predicts dysglycemia and gestational diabetes mellitus in midpregnancy. First‐trimester maternal abdominal adiposity predicts dysglycemia and gestational diabetes mellitus in midpregnancy.