AUTHOR=Raets Lore , Vandewinkel Marie , Van Crombrugge Paul , Moyson Carolien , Verhaeghe Johan , Vandeginste Sofie , Verlaenen Hilde , Vercammen Chris , Maes Toon , Dufraimont Els , Roggen Nele , De Block Christophe , Jacquemyn Yves , Mekahli Farah , De Clippel Katrien , Van Den Bruel Annick , Loccufier Anne , Laenen Annouschka , Devlieger Roland , Mathieu Chantal , Benhalima Katrien 

TITLE=Preference of Women for Gestational Diabetes Screening Method According to Tolerance of Tests and Population Characteristics

JOURNAL=Frontiers in Endocrinology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.781384

DOI=10.3389/fendo.2021.781384

ISSN=1664-2392

ABSTRACT=<sec><title>Aims</title><p>To determine the preferred method of screening for gestational diabetes mellitus (GDM).</p></sec><sec><title>Methods</title><p>1804 women from a prospective study (NCT02036619) received a glucose challenge test (GCT) and 75g oral glucose tolerance test (OGTT) between 24-28 weeks. Tolerance of screening tests and preference for screening strategy (two-step screening strategy with GCT compared to one-step screening strategy with OGTT) were evaluated by a self-designed questionnaire at the time of the GCT and OGTT.</p></sec><sec><title>Results</title><p>Compared to women who preferred one-step screening [26.2% (472)], women who preferred two-step screening [46.3% (834)] were less often from a minor ethnic background [6.0% (50) <italic>vs</italic>. 10.7% (50), p=0.003], had less often a previous history of GDM [7.3% (29) <italic>vs</italic>. 13.8% (32), p=0.008], were less often overweight or obese [respectively 23.1% (50) <italic>vs</italic>. 24.8% (116), p&lt;0.001 and 7.9% (66) <italic>vs</italic>. 18.2% (85), p&lt;0.001], were less insulin resistant in early pregnancy (HOMA-IR 8.9 (6.4-12.3) <italic>vs</italic>. 9.9 (7.2-14.2), p&lt;0.001], and pregnancy outcomes were similar except for fewer labor inductions and emergency cesarean sections [respectively 26.6% (198) <italic>vs</italic>. 32.5% (137), p=0.031 and 8.2% (68) <italic>vs</italic>. 13.0% (61), p=0.005]. Women who preferred two-step screening had more often complaints of the OGTT compared to women who preferred one-step screening [50.4% (420) <italic>vs</italic>. 40.3% (190), p&lt;0.001].</p></sec><sec><title>Conclusions</title><p>A two-step GDM screening involving a GCT and subsequent OGTT is the preferred GDM screening strategy. Women with a more adverse metabolic profile preferred one-step screening with OGTT while women preferring two-step screening had a better metabolic profile and more discomfort of the OGTT. The preference for the GDM screening method is in line with the recommended Flemish modified two-step screening method, in which women at higher risk for GDM are recommended a one-step screening strategy with an OGTT, while women without these risk factors, are offered a two-step screening strategy with GCT.</p></sec><sec><title>Clinical Trial Registration</title><p>NCT02036619 <uri xlink:href="https://clinicaltrials.gov/ct2/show/NCT02036619" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov/ct2/show/NCT02036619</uri></p></sec>