Repeated oral glucose tolerance tests in women at risk for gestational diabetes mellitus

Wit, Leon de; Bos, D; Rossum, André P van; Rijn, Bas B. van; Boers, Kim E.

doi:10.1016/j.ejogrb.2019.09.022

Cited by 12 publications

(23 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Few studies investigating late pregnancy screening have been conducted. A study ( 16 ) reported that the rates of macrosomia (16.3% vs. 35.3%, P =0.011) and LGA (18.6% vs. 39.7%, P =0.018) were lower in individuals with abnormal blood glucose levels than in those with NBG levels in late pregnancy. We did not show that supplementary diagnosis in late pregnancy improved the short-term perinatal outcomes.…”

Section: Discussionmentioning

confidence: 98%

“…Few studies have employed repeat OGTT in late pregnancy. A Dutch study ( 16 ) reported that 23.5% of pregnant women were diagnosed with GDM based on a second OGTT in late pregnancy. In our study, 174 pregnant women in the experimental group who had normal OGTT results in the first and middle periods underwent a repeat OGTT in late pregnancy, and 32 (18.39%) of the 174 pregnant women received a supplementary diagnosis, with the diagnosis rates being similar in middle and late pregnancy (13.44% vs 10.49%).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, this study found that previous GDM was a risk factor for HIP diagnosis in late pregnancy. Despite few relevant studies, the correlation between previous GDM and HIP diagnosis in late pregnancy (OR=2.6, 95% CI: 1.0–6.3) has been reported ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Sequential Screening Strategy in Early, Middle, and Late Pregnancy in Women at High Risk of Hyperglycemia

Wang

Zhang

et al. 2022

Front. Endocrinol.

View full text Add to dashboard Cite

BackgroundHyperglycaemia in pregnancy (HIP) is closely associated with short- and long-term adverse fetal and maternal outcomes. However, the screening and diagnostic strategies for pregnant women with risk factors for HIP are not set. This prospective study aimed to explore a screening strategy for women at high risk for HIP.MethodsA total of 610 pregnant women were divided into experimental (n=305) and control (n=305) groups. Pregnant women underwent a 75-g OGTT in early (<20 weeks), middle (24–28 weeks), and late pregnancy (32–34 weeks) in the experimental group and only in middle pregnancy in the control group. The general conditions, HIP diagnosis, and perinatal outcomes of the two groups were compared.ResultsIn the experimental group, HIP was diagnosed in 29.51% (90/305), 13.44% (41/305), and 10.49% (32/305) of patient in early, middle, and late pregnancy, respectively. The total HIP diagnosis rate was significantly higher in the experimental group (53.44% vs. 35.74%, P<0.001). Multivariate logistic regression analysis revealed that previous gestational diabetes mellitus (GDM) (odds ratio, OR=9.676, P<0.001), pre-pregnancy body mass index (BMI) ≥23 kg/m2 (OR=4.273, P<0.001), and maternal age ≥35 years (OR=2.377, P=0.010) were risk factors for HIP diagnosis in early pregnancy. Previous GDM (OR=8.713, P=0.002) was a risk factor for HIP diagnosis in late pregnancy. No significant differences in perinatal clinical data were observed between the experimental and control groups. The gestational age at delivery was significantly earlier in the experimental subgroup with early-HIP than in the experimental and control subgroups with normal blood glucose (NBG). The weight gain during pregnancy was lower in the experimental early-HIP, middle-HIP, and control NBG subgroups.ConclusionsWe recommend sequential screening in early and middle pregnancy for high-risk pregnant women with maternal age ≥35 years or pre-pregnancy BMI ≥23 kg/m2, and in early, middle, and late pregnancy for high-risk pregnant women with a previous history of GDM.Trial RegistrationThis study was registered in the Chinese Clinical Trial Registry (no. ChiCTR2000041278).

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sequential Screening Strategy in Early, Middle, and Late Pregnancy in Women at High Risk of Hyperglycemia

Wang

Zhang

et al. 2022

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…In most protocols, a negative GTT at weeks 24 to 28 is not repeated later in pregnancy. However, several studies have shown that repeat testing after an initially normal GTT will identify additional cases in 4 to 29 percent of cases, depending on the timing and indication for retesting (29) . Recurrent GTT may be considered on an individualized basis in women with sonographic findings suggestive of a diagnosis of gestational diabetes, such as fetal overgrowth or polyhydramnios, or in women with a past history of gestational diabetes.…”

Section: Retestmentioning

confidence: 99%

Screening of Diabetes in Pregnancy

Sever¹,

Pala²

2021

Terh

View full text Add to dashboard Cite

The prevalence of gestational diabetes mellitus (GDM) is approximately 6% of pregnant women in the United States. The prevalence ranges is about from 2% to 38% worldwide and varies among racial-ethnic groups, often paralleling the prevalence of type 2 diabetes. The prevalence also varies due to differences in screening practices, population characteristics (eg, mean age and body mass index [BMI] of pregnant women), testing method, and diagnostic criteria. The prevalence is increasing over time, possibly due to increases in mean maternal age and weight, particularly with increasing obesity. In 2010, the International Association of Diabetes and Pregnancy Study Groups proposed new screening and diagnostic criteria for diabetes in pregnancy. Using these criteria, the global prevalence of hyperglycemia in pregnancy is estimated at 17%, with regional estimates ranging from 10% in North America to 25% in Southeast Asia. Different screening programs are carried out in different clinics, and all these differences lead to different results in the frequency of GDM. The criteria of the method and threshold value acceptance depends on the health policies of the countries, the experience of the clinicians and the characteristics of the patient population. In this review, we analyzed the methods recommended for GDM screening in pregnancy.

show abstract

“…Figure 2 demonstrates the two-step approach for GDM screening at 24 -28 weeks of gestation. This recommendation is based on the findings of studies that showed that repeated screening can detect additional cases of GDM, especially in high-risk women (31,32). In such cases, the use of the one-step approach with 75 g oral glucose or a two-step approach (considered positive with only one abnormal glucose result) is less risky.…”

Section: Screening Diabetes In Pregnant Women With Negative First Scrmentioning

confidence: 99%

Iranian Endocrine Society Guidelines for Screening, Diagnosis, and Management of Gestational Diabetes Mellitus

Hosseinpanah

Tehrani

Abdi

et al. 2020

Int J Endocrinol Metab

View full text Add to dashboard Cite

Context: Gestational diabetes mellitus (GDM) is an important endocrine disorder in perinatology, associated with several maternal and neonatal complications. Development of national guidelines can inform clinicians, health policymakers, and researchers about the most recent evidence and practical issues of diagnosis and management of GDM. Objectives: We aimed to develop clinical practice guidelines for the diagnosis and management of GDM in Iranian pregnant women. Evidence Acquisition: The Iranian Endocrine Society constituted a task force, consisting of obstetrician-gynecologists, endocrinologists, a clinical nutritionist, a clinical epidemiologist, and a librarian, to review the published literature and propose national guidelines for the diagnosis and management of GDM. The consensus was reached on all recommendations in several group meetings with a majority decision. The evidence and recommendations were graded according to the American College of Physicians’ Guideline Grading System. Results: The proposed guidelines included recommendations for screening, diagnosis, and management of GDM in Iran. Conclusions: By using an evidence-based approach, these national GDM guidelines can address important clinical issues in the diagnosis and management of Iranian women with GDM.

show abstract

Repeated oral glucose tolerance tests in women at risk for gestational diabetes mellitus

Cited by 12 publications

References 38 publications

Sequential Screening Strategy in Early, Middle, and Late Pregnancy in Women at High Risk of Hyperglycemia

Sequential Screening Strategy in Early, Middle, and Late Pregnancy in Women at High Risk of Hyperglycemia

Screening of Diabetes in Pregnancy

Iranian Endocrine Society Guidelines for Screening, Diagnosis, and Management of Gestational Diabetes Mellitus

Contact Info

Product

Resources

About