GSB 7.1 Standardlösung

Screening for gestational diabetes

Since 2012, pregnant women without known diabetes in Germany have been offered a two-stage screening for gestational diabetes in accordance with the maternity directive of the G-BA (maternity directive of the G-BA). The screening consists of a pre-test using 50g of glucose (glucose challenge test, GCT), which should be carried out between the 24th and 28th week of pregnancy, regardless of the time of day and recent food intake. If the result is abnormal, a diagnostic test using 125g of glucose (oral glucose tolerance test, oGTT) is carried out. In contrast to the maternity directive of the G-BA, the German guideline for gestational diabetes recommends a one-step screening approach using the diagnostic test (Schäfer-Graf et al. 2018).

Key messages

  • 9 out of 10 pregnant women who gave birth in a hospital in 2019 were tested at least once for gestational diabetes.
  • Since 2016, the proportion of women who gave birth in a hospital and received a test for gestational diabetes has increased.
  • Two-thirds of women with hospital birth only received the pre-test, 17.8% received both the pre-test and the diagnostic test, and 7.1% only received the diagnostic test.

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trend

Indikatoren_ScreenreaderHinweis_Datentabelle

cross-section

By state

Indikatoren_ScreenreaderHinweis_Datentabelle

  • By gender

    Indikatoren_ScreenreaderHinweis_Datentabelle

  • By age

    Indikatoren_ScreenreaderHinweis_Datentabelle

  • By education group

    Indikatoren_ScreenreaderHinweis_Datentabelle

Results

In 2019, 90.7% of women who gave birth in a hospital were tested at least once for gestational diabetes. Of these, 65.7% only received a pre-test, 7.1% only the diagnostic test, and 17.8% both tests. In the younger age groups (up to 35 years), around two thirds of women only received the pre-test. This proportion is lower in the older age groups and the proportion of women who only received the diagnostic test or underwent both tests is correspondingly higher. A comparison over time shows that the proportion of women with hospital birth without a documented test fell from 16.6% in 2016 to 9.3% in 2019, and that the proportion of women who received at least one test increased over the same period (2016: 83.4%, 2019: 90.7%). This trend can be seen across all federal states, however in 2019 there is still a substantial difference of women tested for gestational diabetes between the federal states. While in Saxony-Anhalt 94.6% of women are tested at least once for gestational diabetes during their pregnancy, in Bremen only 83.5% of women have received a test.

Conclusion

The screening participation has increased over time, and documentation shows that 9 out of 10 women are tested for gestational diabetes. In an earlier analysis using data from the KBV from 2014/15, this proportion was significantly lower at 80.8% (Melchior et al. 2017). The screening participation has then increased over time, as evidenced by follow-up analyses by KBV. The majority of women follows the recommendation of the maternity directive and they either only received a pre-test or a pre-test followed by a diagnostic test. Only a smaller proportion of pregnant women only received the diagnostic test. Further analyses should address which women are currently not reached by screening and whether they differ in important risk factors for gestational diabetes.

Show more information on methodology and data sources

Definition

The indicator Screening for gestational diabetes is defined as the proportion of women giving birth in hospital without pre-existing diabetes in a given year, for whom a pretest and/ or diagnostic test for gestational diabetes is documented in their maternity logs.

Reference population

All women who gave birth in hospital in Germany after exclusion of women with pre-existing diabetes mellitus (approximately 1 % of all women).

Data source

Quality assurance perinatal medicine (obstetrics) at the IQTIG since 2015 based on the perinatal statistics provided by the federal states. This source provides data on all of the approximately 700,000 births that occur in German hospitals annually.

Calculation

  • Observed values: The quotient of the number of women who gave birth in hospital and documented screening for gestational diabetes recorded in their maternity log in relation to all women who gave birth in hospital after exclusion of women with pre-existing diabetes. The analysis was calculated stratified by the following groups: "Pre-test only", "Diagnostic test only" and "Pre- and diagnostic test". The stratification by federal state reflects the location of the hospital in which the birth took place.

Data quality

As the data set is provided by hospitals, it only contains information on births that occurred in a hospital setting, as the data is entered by the hospitals. Therefore, the dara of births that take place outside of hospitals, which are less than 2 % of all birth, are not included. As documentation of gestational diabetes in maternity logs might be incomplete, it is possible that prevalence is being underestimated.

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