Screening for gestational diabetes in the Lombardy region: A population-based study.
AIM
As the treatment of hyperglycaemia during pregnancy with diet or insulin reduces the risk of adverse maternal outcomes and perinatal complications, screening for gestational diabetes mellitus (GDM) is included, albeit to variable extents, in all guidelines of care for pregnant women. The aim of the present investigation was to estimate the proportion of pregnancies screened for GDM in Lombardy between 2007 and 2010, and to identify predictors of screening.


METHODS
A retrospective cross-sectional study using regional healthcare utilization databases of Lombardy was conducted. The study included all residents of Lombardy without pregestational diabetes who delivered between 1 January 2007 and 31 December 2010. The proportion of pregnancies with at least one screening test for GDM was calculated, along with the odds ratios and 95% confidence intervals associated with selected covariates for GDM screening.


RESULTS
Of the 362,818 pregnancies included in the sample, 30% were screened for GDM. The proportion of pregnancies screened increased slightly from 2007 (27%) to 2010 (33%) and with maternal age (from 28% among women<25 years to 32% among those ≥35 years), and varied widely across local health management organizations (HMOs) of residence (range: 20% to 68%). Socioeconomic indicators (education, immigrant status), obstetric history and prepregnancy hypertension were independent predictors of GDM screening.


CONCLUSION
The study finding of a low rate of pregnant women screened for GDM among residents of Lombardy supports the need for programmes to improve training of healthcare professionals, to raise women's awareness of GDM and to eliminate barriers to GDM screening.
['Nicotra|F|F|', 'Molinari|C|C|', 'Dozio|N|N|', 'Castiglioni|M T|MT|', 'Ibrahim|B|B|', 'Zambon|A|A|', 'Corrao|G|G|', 'Scavini|M|M|']
D000328:Adult D001724:Birth Weight D003430:Cross-Sectional Studies D016640:Diabetes, Gestational D005260:Female D005951:Glucose Tolerance Test D006801:Humans D007231:Infant, Newborn D007558:Italy D008403:Mass Screening D011247:Pregnancy D011256:Pregnancy Outcome D011296:Prenatal Diagnosis D012189:Retrospective Studies D055815:Young Adult
Screening Gestational diabetes mellitus Predictors Cross-sectional study Healthcare utilization databases Oral glucose tolerance test