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Title: Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: A cohort study
Authors: Chong Y.-S. 
Cai S. 
Lin H.
Soh S.E. 
Lee Y.-S. 
Leow M.K.S. 
Chan Y.-H. 
Chen L.
Holbrook J.D.
Tan K.-H.
Rajadurai V.S.
Yeo G.S.H.
Kramer M.S. 
Saw S.-M. 
Gluckman P.D. 
Godfrey K.M.
Kwek K.
Agarwal P.
Biswas A. 
Bong C.L.
Broekman B.F.P.
Yen Chan J.K. 
Chee C.Y.I.
Chen H.Y.H. 
Cheung Y.B. 
Chia A.
Chinnadurai A.
Chng C.K.
Chong M.-F.-F. 
Chong S.C. 
Chua M.C.
Ding C.M.
Finkelstein E.A. 
Fok D.
Fortier M.
Goh A.E.N.
Goh Y.T.D. 
Gooley J.J. 
Han W.M.
Hanson M.
Henry C.J. 
Hsu C.-Y. 
Inskip H.
Kapur J. 
Lau I.Y.-M.
Lee B.W. 
Lek N.
Lim S.K.
Low Y.-L.
Magiati I. 
Daniel L.M.
Meaney M.
Ngo C.
Naiduvaje K.
Pang W.W. 
Qiu A. 
Quah B.L.
Rauff M.
Rebello S.A. 
Richmond J.L.
Rifkin-Graboi A.
Shek L.P.-C. 
Sheppard A.
Shuter B.
Singh L. 
Stunkel W.
Su L.L. 
Teoh O.H.
Tint M.T. 
van Bever H.P.S. 
van Dam R.B. 
Wong I.B.Y. 
Wong P.C.
Yap F. 
Keywords: Universal screening
High risk screening
Gestational diabetes
Issue Date: 2-Oct-2014
Publisher: BioMed Central Ltd.
Citation: Chong Y.-S., Cai S., Lin H., Soh S.E., Lee Y.-S., Leow M.K.S., Chan Y.-H., Chen L., Holbrook J.D., Tan K.-H., Rajadurai V.S., Yeo G.S.H., Kramer M.S., Saw S.-M., Gluckman P.D., Godfrey K.M., Kwek K., Agarwal P., Biswas A., Bong C.L., Broekman B.F.P., Yen Chan J.K., Chee C.Y.I., Chen H.Y.H., Cheung Y.B., Chia A., Chinnadurai A., Chng C.K., Chong M.-F.-F., Chong S.C., Chua M.C., Ding C.M., Finkelstein E.A., Fok D., Fortier M., Goh A.E.N., Goh Y.T.D., Gooley J.J., Han W.M., Hanson M., Henry C.J., Hsu C.-Y., Inskip H., Kapur J., Lau I.Y.-M., Lee B.W., Lek N., Lim S.K., Low Y.-L., Magiati I., Daniel L.M., Meaney M., Ngo C., Naiduvaje K., Pang W.W., Qiu A., Quah B.L., Rauff M., Rebello S.A., Richmond J.L., Rifkin-Graboi A., Shek L.P.-C., Sheppard A., Shuter B., Singh L., Stunkel W., Su L.L., Teoh O.H., Tint M.T., van Bever H.P.S., van Dam R.B., Wong I.B.Y., Wong P.C., Yap F. (2014-10-02). Ethnic differences translate to inadequacy of high-risk screening for gestational diabetes mellitus in an Asian population: A cohort study. BMC Pregnancy and Childbirth 14 (1) : article number 345. ScholarBank@NUS Repository.
Abstract: Background: Universal and high-risk screening for gestational diabetes mellitus (GDM) has been widely studied and debated. Few studies have assessed GDM screening in Asian populations and even fewer have compared Asian ethnic groups in a single multi-ethnic population.Methods: 1136 pregnant women (56.7% Chinese, 25.5% Malay and 17.8% Indian) from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study were screened for GDM by 75-g oral glucose tolerance test (OGTT) at 26-28 weeks of gestation. GDM was defined using the World Health Organization (WHO) criteria. High-risk screening is based on the guidelines of the UK National Institute for Health and Clinical Excellence. Results: Universal screening detected significantly more cases than high-risk screening [crude OR 2.2 (95% CI 1.7-2.8)], particularly for Chinese women [crude OR = 3.5 (95% CI 2.5-5.0)]. Pre-pregnancy BMI > 30 kg/m2 (adjusted OR = 3.4, 95% CI 1.5-7.9) and previous GDM history (adjusted OR = 6.6, 95% CI 1.2-37.3) were associated with increased risk of GDM in Malay women while GDM history was the only significant risk factor for GDM in Chinese women (adjusted OR = 4.7, 95% CI 2.0-11.0).Conclusion: Risk factors used in high-risk screening do not sufficiently predict GDM risk and failed to detect half the GDM cases in Asian women. Asian women, particularly Chinese, should be screened to avoid under-diagnosis of GDM and thereby optimize maternal and fetal outcomes. © 2014 Chong et al.; licensee BioMed Central Ltd.
Source Title: BMC Pregnancy and Childbirth
ISSN: 14712393
DOI: 10.1186/1471-2393-14-345
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