Abstract
BackgroundControversies surround a diagnosis of gestational diabetes mellitus (GDM). The objective of this study was to evaluate the oral glucose tolerance test (OGTT) for the prediction of adverse gestational and perinatal outcomes in pregnant women with a positive screening test for diabetes mellitus and a negative diagnosis, i.e. a normal 3-hour OGTT.MethodsThis validation study evaluated 409 pregnant women who tested positive for diabetes mellitus at screening. Perinatal and maternal outcomes were considered. Sensitivity and specificity were calculated for each of the values of the OGTT as a diagnostic test, with the gold standard being perinatal outcome.ResultsThe most frequent risk factors were obesity, arterial hypertension and advanced maternal age. The most common neonatal outcomes were large-for-gestational-age infants, Cesarean delivery and preterm birth. A fasting blood glucose level of 87 mg/dL was the most powerful predictor of adverse perinatal outcome.ConclusionsAt the cut-off level adopted by the American Diabetes Association, gestational OGTT was able to successfully identify in which pregnant women outcome would be unfavorable.
Highlights
Many controversies surround the diagnosis of gestational diabetes mellitus (GDM)
According to the guidelines proposed by IADPSG, only one value above the cut-off limit in the 3hour oral glucose tolerance test (OGTT) is sufficient to justify a diagnosis of GDM
The inclusion criteria consisted of a positive screening test for diabetes mellitus and an OGTT with either only one value above the cut-off level or with all values within the normal range
Summary
Controversies surround a diagnosis of gestational diabetes mellitus (GDM). The objective of this study was to evaluate the oral glucose tolerance test (OGTT) for the prediction of adverse gestational and perinatal outcomes in pregnant women with a positive screening test for diabetes mellitus and a negative diagnosis, i.e. a normal 3-hour OGTT. GDM is diagnosed when two or more values are found to be above the established cut-off limits These recommendations were based on studies conducted by O’Sullivan and Mahan, published in 1964 [2] and adapted by Carpenter and Coustan in 1982 [3]. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommended the adoption of certain markers for screening If one of these markers is present, an oral glucose tolerance test is performed. According to the guidelines proposed by IADPSG, only one value above the cut-off limit in the 3hour OGTT is sufficient to justify a diagnosis of GDM. If applied, this criterion will lead to a diagnosis of GDM in 18-20% of the entire obstetric population [5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
