The task force report raises the possibility that testing should be done earlier but doesn’t make that a recommendation because it lacks the evidence to support such a step.
“It’s important to remember that each case of gestational diabetes affects two people: the expectant mother and the baby,” Wanda K. Nicholson, a task force member, said in a statement reported by the newsletter CQ HealthBeat. “We now have good evidence that screening expectant mothers for gestational diabetes after 24 weeks provides a substantial benefit, with few to no harms, leading to healthier moms and babies.”
Gestational diabetes begins during pregnancy, usually at the half-way point, the task force report notes. It usually disappears after the baby is born, but pregnant women and their babies are at risk for serious health problems if it goes untreated. Those problems include a higher chance of complications during labor and delivery; a greater chance that the woman will develop diabetes later in life; the possibility that babies grow bigger than usual in the womb, also complicating the birth; and babies can be born with low blood sugar and have an increased risk of becoming obese in childhood.
This is the first time the task force has recommended any routine screening for gestational diabetes in pregnant women. In 2008, the panel found that the evidence was insufficient to suggest such tests either before or after 24 weeks. The guidance on testing for women after 24 weeks is a “B” recommendation while the recommendation for screening before 24 weeks remains an “I,” for insufficient.
If these recommendations become final, the health care reform law would require the test for gestational diabetes mellitus in women after 24 weeks to be covered at no cost to the patient as a preventive service.