Impact of changes to national UK Guidance on testing for gestational diabetes screening during a pandemic: a single‐centre observational study

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 128; no. 5; pp. 917 - 920
• Main Authors: van‐de‐l’Isle, Y, Steer, PJ, Watt Coote, I, Cauldwell, M
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-04-2021
• Subjects: Adult; Blood Glucose - analysis; Cohort Studies; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Diabetes mellitus; Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Diagnostic Screening Programs - organization & administration; Diagnostic Screening Programs - standards; Female; Gestational diabetes; Glucose tolerance; Humans; Mass Screening - methods; Mass Screening - trends; Medical screening; Observational studies; Organizational Innovation; Pandemics; Practice Guidelines as Topic - standards; Pregnancy; Program Evaluation; Reproducibility of Results; SARS-CoV-2; screen; State Medicine - standards; United Kingdom - epidemiology; United Kingdom; United Kingdom > UK; Covid-19; screen; gestational diabetes
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/1471-0528.16482

Objective
To examine the differences in detection rate for gestational diabetes (GDM) comparing the methodology recommended by the National Institute for Health and Clinical Excellence (NICE) compared with testing described as appropriate during the Covid‐19 pandemic by the Royal College of Obstetricians and Gynaecologists (RCOG).
Design
Cohort study of women delivering between 1 January 2016 and 1 July 2020.
Setting
London Teaching Hospital.
Population
All women delivering between 1 January 2016 and 13 May 2020 and follow up of women screening negative between 1 April 2020 and 13 May 2020.
Methods
Retrospective study of prospectively collected data.
Main outcome measures
Detection rate of gestational diabetes.
Results
Using the RCOG guidance, the overall rate of women identified as having gestational diabetes fell from 7.7% (1853/24168) to 4.2% (35/831)(P = 0.0003). Of 230 women who tested negative according to the RCOG criteria from 1 April to 13 May but who subsequently had an oral glucose tolerance test, 47 (20.4%) were diagnosed as having gestational diabetes according to the NICE criteria.
Conclusions
In our setting, the RCOG Covid‐19 gestational diabetes screening regime failed to detect 47 of 82 (57%) women subsequently identified as gestational diabetics, and therefore cannot be recommended for general use.
Tweetable
Screening for GDM using RCOG Covid criteria reduced detection rates.
Tweetable
Screening for GDM using RCOG Covid criteria reduced detection rates.