Prevalence of Hyperglycemia in Pregnancy using early, standard and late screening: a study in the Primary Care Health in Lima, Peru
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Objective
To determine the prevalence of hyperglycemia in pregnancy (HIP) based on the timing of screening in pregnant women.
Materials and Methods
A cross-sectional study was conducted on pregnant women recruited from February 2019 to August 2022 in four primary care centers in Lima, excluding those with known diabetes. Screening involved an Oral Glucose Tolerance Test with 75 g of glucose at the first contact. It was classified as early if performed before 24 weeks, standard between 24-28 weeks, and late if after 29 weeks. For gestational diabetes mellitus (GDM), we used the IADPSG diagnostic criteria for any gestational age. For diabetes in pregnancy (DIP), glucose levels over 126 mg/dl fasting or over 200 mg/dl at 2 hours post-load were used. We calculated prevalence ratios for GDM and DIP based on the type of screening.
Results
We included 4,495 pregnant women with an average age of 29 years. The prevalence of HIP was 14.9%, GDM was 14.2%, and DIP was 0.7%. Early GDM screening showed a 23% higher prevalence compared to GDM screening at 24-28 weeks, adjusted for age (PR 1.23; 95% CI 1.01 – 1.49; p=0.036). No differences were found for DIP across screening types.
Conclusion
In pregnant women at four primary centers in Lima, one in seven pregnant women (14.9%) had HIP, GDM was 14.2%, and DIP was 0.7%.. Early screening showed the highest proportion of GDM compared to standard or late screening. Longitudinal studies are needed to validate whether this higher early prevalence impacts maternal-perinatal complications.
