Effectiveness of selective risk based screening for Gestational Diabetes (GDM) in Malaysia: A retrospective cohort study based on the National Obstetric Registry (NOR) of Malaysia
- Author:
Muniswaran Ganeshan
;
Shahrul Aiman Soelar
;
Shamala Devi Karalasingam
;
Mohammad Adam Bujang
;
Jeganathan R, M.
;
Harris Suharjono
- Publication Type:Journal Article
- Keywords:
Gestational diabetes;
GDM;
selective screening in Malaysia
- MeSH:
Diabetes, Gestational
- From:
The Medical Journal of Malaysia
2017;72(1):46-49
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Gestational diabetes (GDM) has significant
maternal and foetal implications. screening allows active
interventions which significantly improves pregnancy
outcomes. Despite World Health Organization (WHO), FIGO
and National Institute of clinical Excellence (NIcE)
recommendations for universal screening especially among
high risk population; Malaysia currently adopts a selective
risk based screening for GDM.
Objective: the objective is to audit the effectiveness of the
current practice of selective risk based screening in
detection of GDM in Malaysia.
Methodology: this is a retrospective cohort study based on
the National Obstetric Registry (NOR) which comprises of 14
major tertiary hospitals in Malaysia. the study period was
from 1st January 2011 till 31st December 2012 and a total of
22,044 patients with GDM were analysed. Logistic
regression analysis was used to calculate the crude odd
ratio.
Results: the incidence of GDM in Malaysia is 8.4%. Maternal
age of ≥25, booking bMI ≥27kg/m2, booking weight ≥80kg
and previous hypertension are non-significant risk of
developing GDM in Malaysia. Parity 5 and more was only
associated with an odds-ratio of 1.02 (95% confidence
Interval: 0.90-1.17) as compared to parity below 5. the
association of women with previous stillbirth with GDM was
not significant.
conclusion: current risk based screening for GDM based on
maternal age, booking bMI, weight and hypertension is
inappropriate. An ideal screening tool should precede
disease complications, which is the novel objective of
screening. Universal screening for GDM in Malaysia may be
a more accurate measure, especially with regards to
reducing maternal and foetal complications.
- Full text:P020170303573788350554.pdf
