At what gestational age does the USPSTF recommend screening for gestational diabetes in asymptomatic pregnant women?

• A. At 24 weeks of gestation or after
• B. At 12 weeks of gestation
• C. Only in the first trimester
• D. Only after delivery

Answer: (A)

Midpregnancy is the right window for gestational diabetes screening in asymptomatic pregnant women. The USPSTF recommends screening for gestational diabetes at about 24 to 28 weeks of gestation, and if not done by then, screening can occur later in pregnancy. This timing aligns with the rise in insulin resistance driven by placental hormones during the second trimester, so most cases become detectable in this interval, allowing timely management to reduce maternal and fetal complications.

Screening earlier than 24 weeks (for example, at 12 weeks) would miss many cases that develop later in pregnancy. Screening only in the first trimester is not appropriate for universal GDM screening. Screening only after delivery would not address gestational diabetes during the pregnancy at all.