A clinical and economic evaluation of screening and diagnostic tests to identify and treat women with gestational diabetes: association between maternal risk factors, glucose levels, and adverse outcomes

Insulin resistance increases during pregnancy so that glucose (sugar) can cross the placenta to feed the growing fetus. If insulin resistance becomes too great, blood glucose levels increase and gestational diabetes is diagnosed. Women who develop gestational diabetes and their infants are more likely to suffer problems during pregnancy and soon after birth, including Caesarean birth, birth injury and require longer hospital stay and higher levels of care whilst in hospital. Women who develop gestational diabetes are more likely to develop gestational diabetes in a subsequent pregnancy and become permanently diabetic after pregnancy. The infants of women who have had gestational diabetes are more likely to be born large and be fatter in later life; these infants also seem to have more chance of developing diabetes and heart disease as they get older. Identifying and treating women with gestational diabetes is important so that these problems may be reduced or prevented.

The researchers expect to be able to find out when the best time in pregnancy is to screen and administer diagnostic tests and what treatment is most effective Experienced researchers from the Bradford Institute for Health Research, the University of Bristol and the University of York will work together to ensure the aims and objectives of the project are completed within the specified time frame. The team includes individuals with obstetric, midwifery, endocrinology, research (statistics, study design, literature searching) and health economics knowledge and skills. Importantly, members of the team have experience in undertaking systematic reviews of the literature, statistical analysis, epidemiology and economic modelling and we have worked together on the Born in Bradford study and other studies relevant to this proposal. We know therefore that we are able to work and collaborate effectively and can complete good research that is relevant to the NHS, clinical practice and pregnant women.