Simplifying the screening of gestational diabetes by maternal age plus fasting plasma glucose at first prenatal visit: A prospective cohort study

Yi Yun Tai, Chien Nan Lee, Chun Heng Kuo, Ming Wei Lin, Kuan Yu Chen, Shin Yu Lin*, Hung Yuan Li

*此作品的通信作者

研究成果: Article同行評審

7 引文 斯高帕斯(Scopus)

摘要

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.

原文English
文章編號e0237224
期刊PLoS ONE
15
發行號8 August
DOIs
出版狀態Published - 8月 2020

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