Gestational diabetes: Fasting and postprandial glucose as first prenatal screening tests in a high-risk population

Mukesh M. Agarwal, Gurdeep S. Dhatt, John Punnose, Reem Zayed

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the value of fasting (FPG) and 2-hour postprandial (PPG) plasma glucose as screening tests for gestational diabetes mellitus (GDM) in a high-risk population during early pregnancy. STUDY DESIGN: At their first prenatal visit, 708 women underwent FPG and PPG for universal screening for GDM, with the diagnosis confirmed by the 75-g oral glucose tolerance test (World Health Organization criteria). The area under the receiver operating characteristic curve (AUC) was used to analyze the performance of the 2 screening tests. RESULTS: Of 184 (25.9%) women with GDM, 79 (42.9%) were identified before 18 weeks. The AUC for FPG to predict GDM was 0.579 (95% CI 0.531-0.627). Though a threshold of 85 mg/dL achieved minimally acceptable sensitivity, 79.9%, the corresponding specificity remained poor, 27.5%, with a false positive rate (FPR) of 72.5%. The AUC for PPG was 0.717 (95% CI 0.670-0.765); a cutoff of 95 mg/dL achieved a sensitivity of 79.9% and FPR of 53.1%. CONCLUSION: Though GDM could be diagnosed in > 40% women in early pregnancy at their first prenatal visit, the poor specificity and high FPR of FPG and PPG, alone or in combination, make them unsuitable screening tests for GDM.

Original languageEnglish
Pages (from-to)299-305
Number of pages7
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume52
Issue number4
Publication statusPublished - Apr 2007
Externally publishedYes

Keywords

  • Gestational diabetes
  • Glucose tolerance test
  • Mass screening
  • Oral glucose tolerance test

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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