Gestational diabetes: universal or selective screening in pregnancy?

Gestational diabetes mellitus (GDM) is one of the most frequent complications of pregnancy. Despite international efforts, there is no consensus regarding the optimal method of screening and diagnosis of GDM. Some organizations propose screening only for women with high risk of GDM, while others suggest testing all pregnant women. Furthermore, there are more types of screening and diagnostic tests (one vs. two-step approach) with different glycemic thresholds. The aim of this review is to present and compare the screening and diagnosis guidelines of the most influential organizations. Additionally, this study evaluates the differences between selective and universal screening. The necessity for a consensus and for a single acceptable guideline has been repeatedly highlighted by experts in order to allow uniform clinical practice and to improve perinatal and maternal outcomes.