Risk Factor-Based Selective Screening Program for Gesta
tional Diabetes Mellitus in Siriraj Hospital : Result from
Clinical Practice Guideline
PRASERT SUNSANEEVITHA Y AKUL, MD*, DITTAKARN BORIBOOHIRUNSARN, MD, PhD*,
ANUW AT SUTANTHA VIBUL, MD*, PORNPIMOL RUANGVUTILERT, MD, PhD*,
SUJIN KANOKPONGSAKDI, MD*, DARUNEE SINGKIRATANA, BNS**,
SRISA W AT BUNY A W ANICHKUL, BNS**
Affiliation : * Department of Obstetrics and Gynecology,
** Obstetrics and Gynecology Nursing, Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok 10700, Thailand.
AbstractA clinical practice guideline for the screening and diagnosis of gestational diabetes mellitus
(GDM) is currently implemented at Siriraj Hospital. During the year 2000, a total of 9325 pregnant
women were screened for clinical risk factors during their first antenatal visits, and 3770 had at least
I risk. After the 50 g glucose challenge test and 100 g oral glucose tolerance test, GDM was diagnosed
in 235 women. The incidence of GDM was 6.2 per cent (95% CI 5.5-7.1) among high-risk pregnant
women, and 2.5 per cent (95% CI 2.2-2.9) of all pregnant women. Significant risk factors identified
from the present study were family history of DM (adjusted OR 1.86, 95% CI 1.38-2.51), age~ 30 years
(adjusted OR 2.41, 95% CI 1.72-3.39), history of unexplained intrauterine fetal death (adjusted OR 4.30,
95% CI 2.04-9.04), and obesity (adjusted OR 2.83, 95% CI 1.88-4.25). The risk of developing GDM
also increased when more than 1 clinical risk factor was identified. The results support the value of this
screening program for GDM. Every obstetrician should be aware of the need to screen for GDM in
every pregnant woman and a similar program should also be introduced to other settings.
Keywords : Gestational Diabetes, Risk Factor, Selective Screening
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