Ontology highlight
ABSTRACT: Aim
The addition of maternal age to fasting plasma glucose (FPG) at 24-28 gestational weeks improves the performance of GDM screening as maternal age increases. However, this method delays the diagnosis of GDM. Since FPG at the first prenatal visit (FPV) is a screening option for pre-existing diabetes, we evaluated the performance of age plus FPG at the FPV to reduce the need for the OGTT.Methods
Pregnant women were recruited consecutively in 2013-2018 (the training cohort) and 2019 (the validation cohort). We excluded women with twin pregnancies, unavailable FPG at the FPV or OGTT data, pre-pregnancy diabetes, or a history of GDM. All participants underwent FPG and haemoglobin A1c (HbA1c) at the FPV and received 75-g OGTT at 24-28 gestational weeks if FPG at the FPV was <92 mg/dL. GDM was diagnosed by the IADPSG criteria. Two algorithms were developed with the cutoffs determined when the percentage requiring OGTT (OGTT%) was the lowest and the sensitivity was ≥90%.Results
The incidence of GDM increased with age. The "FPG at the FPV" algorithm reduced OGTT% to 68.8% with the FPG cutoff at 79 mg/dl. The "age plus FPG at the FPV" algorithm, with the cutoff of 114, further reduced OGTT% to 58.3%, with the sensitivity of 90.7% (9.3% GDM missed) and the specificity of 100%. These findings were replicated in the validation cohort.Conclusions
Screening GDM by maternal age plus FPG at the FPV can reduce OGTT%, especially in populations with a significant proportion of pregnant women with advanced ages.
SUBMITTER: Tai YY
PROVIDER: S-EPMC7444589 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
Tai Yi-Yun YY Lee Chien-Nan CN Kuo Chun-Heng CH Lin Ming-Wei MW Chen Kuan-Yu KY Lin Shin-Yu SY Li Hung-Yuan HY
PloS one 20200820 8
<h4>Aim</h4>The addition of maternal age to fasting plasma glucose (FPG) at 24-28 gestational weeks improves the performance of GDM screening as maternal age increases. However, this method delays the diagnosis of GDM. Since FPG at the first prenatal visit (FPV) is a screening option for pre-existing diabetes, we evaluated the performance of age plus FPG at the FPV to reduce the need for the OGTT.<h4>Methods</h4>Pregnant women were recruited consecutively in 2013-2018 (the training cohort) and 2 ...[more]