After a local study done by Duke-NUS and KK Women’s and Children’s Hospital (KKH) revealed that gestational diabetes mellitus (GDM) can be more easily detected in expectant mothers who are 24 to 28 weeks pregnant, KKH has launched a pilot project at the start of 2016 offering GDM screening to all pregnant women.

More efficient than targeted screening

The study, headed by Dr Petty Chen, and under the mentorship of Professor Tan Kok Hian and Professor Eric Finkelstein, also showed that GDM screening is altogether more efficient than targeted screening, leading to healthcare professionals being able to offer timely help to their patients before complications arise. GDM screening is considerably economical in comparison to targeted, or no screening for the health concern faced by many Asian women during their pregnancy. It has become an increasingly common problem in many countries, and many see the connection to the rising levels of obesity.

Previously in KKH, the patient would be diagnosed with GDM through a risk factor-associated method, where the healthcare professional will be able to provide targeted screening to those women who are at a higher risk of developing GDM, which is known to affect 15% of expectant mothers worldwide. KKH will be using data from the international Hyperglycaemia and Adverse Pregnancy Outcome study, in which it became one of 15 health centres to participate globally.

In Singapore, the National Population and Talent Division (NPTD) has stated that the average age of new mothers is 30, a relatively older age to become a first-time parent. This ties in with increased risks for GDM, which can affect older mothers. Other risk factors include having a body mass index above 30kg/m2, a family history of diabetes, previous occurrences of GDM, macrosomia, polycystic ovarian syndrome (PCOS), pre-eclampsia and/ or hypertension during pregnancy, gaining excessive weight during pregnancy, or having twins or triplets.

Reduction in complications

GDM comes with numerous risks to the mother and child, which could result in premature labour, or having a difficult pregnancy. Earlier detection through GDM screening offered at KKH for all expectant mothers could reduce such complications and result in improved outcomes for mother and child. The healthcare professional would be able to recommend frequent blood sugar level tests to monitor the patients’ health, advice on a customised dietary plan for the duration of the pregnancy, and be able to take other necessary steps in accordance with the patient’s situation. Overall medical intervention in GDM cases can cut complications in pregnancy by up to 40%, reducing adverse prognosis for mother and child.

With the launch of the six-month pilot project, KKH hopes to provide better prenatal support to Singaporean mothers as well as collect more information regarding GDM treatment and supervision practices here and in other countries. MIMS

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