Abstract
Objectives: To assess gestational diabetes mellitus (GDM) diagnosis and screening practices in routine antenatal care in Kazakhstan. Methods: A retrospective cross-sectional study used electronic medical records of pregnant women receiving antenatal care in public outpatient clinics in Aktobe and Uralsk, Kazakhstan, from August 2024 to May 2025. Data were extracted from the DamuMed electronic medical system. A total of 445 pregnant women were included, of whom 229 had at least one GDM risk factor. Descriptive statistics and chi-square tests were used to assess screening practices and factors associated with oral glucose tolerance test (OGTT) performance at 24–28 weeks of gestation. Results: Fasting plasma glucose levels of 5.1–6.9 mmol/L were identified in 22.02% of women, while 1.57% had levels ≥7.0 mmol/L. However, GDM was documented in only 1.12%. Overall, 51.46% of women had at least one GDM risk factor. Among these women, 27.07% underwent OGTT at 24–28 weeks of gestation and 12.66% received an endocrinology consultation. OGTT uptake was significantly associated with elevated fasting plasma glucose, obesity, and a history of fetal macrosomia ( p < 0.05). Conclusions: GDM screening and diagnosis appeared suboptimal, suggesting potential underdiagnosis and gaps in implementing national recommendations. Strengthened screening and referral pathways are needed.