[Screening and management of monthly glycosuria in pregnancy follow-up: an overview of clinical practices in France]

Gynecol Obstet Fertil Senol. 2026 Jul 7:S2468-7189(26)00182-0. doi: 10.1016/j.gofs.2026.06.007. Online ahead of print.
[Article in French]

Abstract

Objective: Historically used for screening gestational diabetes, testing for glycosuria during pregnancy is now controversial. Despite the low diagnostic performance of this test, the "Haute Autorité de Santé" (HAS) recommends performing it at each prenatal visit. However, this practice represents an estimated annual cost of 2 million euros in France. The aim of this study was to evaluate French practices regarding glycosuria prescription and the management adopted by practitioners in case of a positive result.

Materials and methods: An observational study was conducted using a questionnaire distributed to healthcare professionals in France between August 31, 2024, and April 1, 2025. A univariate comparative analysis was performed according to whether glycosuria was prescribed or not, and according to the management implemented in cases of positive glycosuria.

Results: A total of 1,132 responses were collected. Glycosuria was prescribed by 62% of respondents during pregnancy follow-up. In the event of a positive result, 45% of practitioners took no action, 45% prescribed screening for gestational diabetes using fasting blood glucose or an oral glucose tolerance test (OGTT), and 10% reinforced dietary and lifestyle advice during the consultation. Glycosuria prescription was significantly more frequent among midwives (p = 0.04), practitioners working in private practice (p = 0.01), in private healthcare facilities (p = 0.04), and in type 1 maternity units (p = 0.01).

Conclusion: Glycosuria continues to be prescribed by the majority of practitioners, but with highly heterogeneous practices across France and without evaluation of its effectiveness. Glycosuria testing is costly, and its performance in screening for gestational diabetes has not been demonstrated. Reassessment of its role in prenatal care in France appears necessary.

Keywords: Glycosuria; Glycosurie; diabète gestationnel; gestational diabetes; grossesse; pregnancy; pregnancy follow-up; suivi de grossesse.

Publication types

  • English Abstract