Doctors and midwives are being asked to screen all pregnant women for risk factors for gestational diabetes at their first booking appointment and to offer them a test for the condition if their risk is raised.

The recommendation is included in the revised guidance from the National Institute for Health and Clinical Excellence on the routine care that should be offered to all pregnant women in England, which was first published in 2003.

Risk factors for gestational diabetes include a body mass index greater than 30; previous macrosomic baby above 4.5 kg; previous gestational diabetes; family history of diabetes; and family origin with high prevalence of diabetes, such as South Asian, black Caribbean, and Middle Eastern.

The guidance also says that the combined test to screen for Down’s syndrome (nuchal translucency, β human chorionic gonadotrophin, and pregnancy associated plasma protein A) should be offered earlier whenever possible—at between 11 …