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The Challenges for Screening and Diagnosing Gestational Diabetes Mellitus in Brazil: a cross-sectional study in a low-risk obstetric hospital.

Sartorao Filho, C. I.; Takano, L.; Maria, B. M. P.; Fernandes Vivaldo, D. G.; Izidoro, T. S.; Caldeirao, T. D.

2022-01-10 obstetrics and gynecology
10.1101/2022.01.08.22268941 medRxiv
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BackgroundGestational Diabetes Mellitus (GDM) is a very prevalent disease and can cause several morbidities for women and their offspring. The literature demonstrates the necessity for a better approach during prenatal assistance to detect and treat the disease. We aimed to evaluate the model and efficacy of GDM screening and diagnosis in a referenced low-risk obstetrical center of the municipality of Assis, Sao Paulo state, Brazil. Moreover, the specific objective was to evaluate the prevalence of GDM. MethodsWe conducted a retrospective cross-sectional study of pregnant women, in which 257 prenatal cards and the clinical approaches used for GDM diagnosis and their results. We observed the consecutive patients admitted to the low-risk referenced obstetrical service of the "Santa Casa de Assis-SP" for childbirth from January to August 2021. ResultsThere were 257 pregnant women, 227 prenatal cards obtained. Of these, 24.6% of the cards were considered incomplete, 25 (9.72%) did not contain the initial fasting plasma glucose information, and 93 (36.18%) did not describe this information in the second to the third trimester. The prevalence of GDM in the population was 14.78%. ConclusionWe observed many pregnant women not screened according to the recommended guidelines and many prenatal cards with incomplete information. According to the screening and diagnosis guidelines, GDM prevalence was underestimated. The lack of prenatal card information and inadequacy of screening and diagnoses were observed in this population.

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