Is gestational diabetes a clinical entity?

`Gestational diabetes' is defined as abnormal glucose tolerance appearing for the first time in pregnancy. However, it is difficult to establish an important relationship between this diagnosis and poor perinatal outcome. There is little evidence, therefore, that screening for the condition with a glucose tolerance test (GTT) will provide significant improvement in obstetrical results. It is likely that maternal age and weight can predict women at risk of perinatal loss with equal or greater effectiveness. Focus on GTTs may lead the clinician to neglect more important factors associated with perinatal loss. Attention to the currently accepted risk factors of maternal age, stature, and post-obstetric history, together with careful assessment of fetal growth, should be the approach to care in patients at risk from gestational diabetes.