Risk factors for gestational diabetes mellitus in the Maltese population : a population based study

Abstract

Screening criteria for carbohydrate metabolism problems during pregnancy include the use of specified historic risk factors, which are generally considered to be inadequate. The value of these historic risk factors in a population characterized by a high prevalence of carbohydrate metabolism problems is investigated. The study identified biological characteristics such as elderly maternal age, a high maternal BMI, and multiparity as significant risk factors for the development of GDM. A previous history of Caesarean delivery or macrosomia was similarly associated. There appeared to be no association with a history of previous early pregnancy or perinatal loss, or congenital anomalies. Women identified to have G-IGT did not show any significant clinical risk factors. The risk factors for the development of GDM are shown to have a high specificity and negative predictive value, but overall low sensitivity and positive predictive value when used in isolation. These features suggest that while the historic risk criteria are not ideal screening tools, they still have an important role in situations where routine screening with an oGTT is unavailable or impractical provided they are used in combination.