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MS WordPerinatologist Corner - C.E.U/C.M.E. Modules
Diabetes In Pregnancy Series
Sponsored by The Indian Health Service Clinical Support Center
PART 1: Screening and Diagnosis
3. Risk Factors
The woman in our case study has several risk factors for developing diabetes during pregnancy. She has a history of:
- macrosomic
infants over 4000g (8 lbs. 14 oz.)
- prior term intrauterine fetal demise
- AI/AI ethnicity
- age over 35 years
Other risk factors, still unknown in this case, include:
History:
-family history of first degree relatives with
diabetes
-gestational diabetes in a previous pregnancy
-overweight
(pre-pregnancy weight ≥ 110
% of ideal
body weight) (P D F)
(pre-pregnancy weight BMI ≥ 27)
-prior infant with a birth defect or congenital anomaly
-habitual abortion ( ≥ 3
consecutive SAB)
-ethnic background: African American, Asian, Hispanic, Pacific Islander
Current
pregnancy:
- unexplained polyhydraminos
- persistent glycosuria
Screening for gestational diabetes (GDM) may be carried out on the basis of risk factors, but that strategy will still miss approximately half of the women with GDM. (Whether or not that is significant, will be discussed subsequently....) However, in the AI/AN population, which has such a high prevalence of the disorder, universal screening is appropriate. Likewise, many patients in our population may have undiagnosed preexisting type II diabetes, and these patients are definitely at higher risk from a perinatal standpoint.
