Retrospective review of GCT cutoff value based on pre-pregnancy BMI class in patients with GDM
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Kajal Angras
,
Victoria Boyd
Abstract
Objectives
To determine the optimal glucose challenge test (GCT) cutoff value for the screening of gestational diabetes mellitus (GDM) based on pre-pregnancy BMI.
Methods
An-IRB approved retrospective cohort analysis of singleton pregnancies at a large tertiary healthcare center from January 2004 to December 2020 was performed. The first GCT value completed between 20 and 32 weeks was used. Using a receiver operator curve (ROC), we sought to determine the optimal GCT cutoff value for each BMI category that would predict the development of GDM. Youden Index was used to determine optimal cut-point of GCT values for each BMI class.
Results
A total of 23,550 patients with a GCT value were identified. Of those, 1,676 (7.1%) were diagnosed with GDM. 513 (30.6%) with normal BMI, 449 (26.8%) overweight, 347 (20.7%) class I obese, 210 (12.5%) class II obese, and 157 (9.4%) class III obese patients were diagnosed with GDM. Gestational diabetes was predicted at GCT cutoff value of 130 mg/dL with an area under the curve (AUC) of 0.92 (BMI <25), 131 mg/dL with an AUC of 0.92 (overweight BMI), 131 mg/dL with an AUC of 0.89 (class I BMI), 133 mg/dL with an AUC of 0.88 (class II BMI), and 131 mg/dL with an AUC of 0.88 (class III BMI).
Conclusions
AUC ranged from 0.88 to 0.92 with 93% or greater sensitivity for GCT cutoff value across each of the BMI categories. The findings support a GCT cutoff value of 130 mg/dL for GDM screening regardless of BMI.
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Research funding: The research was supported and funded by Geisinger Clinic.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: Geisinger’s Institutional Review Board approval was obtained for the study.
References
1. Bardenheier, BH, Imperatore, G, Gilboa, SM, Geiss, LS, Saydah, SH, Devlin, HM, et al.. Trends in gestational diabetes among hospital deliveries in 19 U.S. states, 2000–2010. Am J Prev Med 2015;49:12–9. https://doi.org/10.1016/j.amepre.2015.01.026.Search in Google Scholar PubMed PubMed Central
2. Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin no. 190: gestational diabetes mellitus. Obstet Gynecol 2018;131:e49–64.10.1097/AOG.0000000000002501Search in Google Scholar PubMed
3. Temming, LA, Tuuli, MG, Stout, MJ, Macones, GA, Cahill, AG. Diagnostic ability of elevated 1-h glucose challenge test. J Perinatol 2016;36:342–6, https://doi.org/10.1038/jp.2015.215.Search in Google Scholar PubMed PubMed Central
4. Lanni, S, Barrett, D. The predictive value of the 1-h 50-g glucose screen for diagnosing gestational diabetes mellitus in a high-risk population. J Matern Fetal Neonatal Med 2004;15:375–9, https://doi.org/10.1080/14767050410001724308.Search in Google Scholar PubMed
5. Figueroa, D, Landon, MB, Mele, L, Spong, CY, Ramin, SM, Casey, B, et al.. Relationship between 1-hour glucose challenge test results and perinatal outcomes. Obstet Gynecol 2013;121:1241–7. https://doi.org/10.1097/aog.0b013e31829277f5.Search in Google Scholar PubMed PubMed Central
6. Subramaniam, A, Jauk, VC, Tita, A, Harper, LM. Interaction between maternal obesity and 1-hour glucose challenge test results on maternal and perinatal outcomes. Am J Perinatol 2015;32:771–8, https://doi.org/10.1055/s-0034-1396695.Search in Google Scholar PubMed
7. Temming, LA, Tuuli, MG, Stout, MJ, Macones, GA, Cahill, AG. Maternal and perinatal outcomes in women with insulin resistance. Am J Perinatol 2016;33:776–80, https://doi.org/10.1055/s-0036-1572434.Search in Google Scholar PubMed PubMed Central
8. MacGregor, C, Has, P, Nardella, D, Werner, E. Comparing glucose challenge test screening thresholds in obese and overweight gravidas. Am J Perinatol 2021;38:273–7, https://doi.org/10.1055/s-0039-1696674.Search in Google Scholar PubMed
9. Juntarat, W, Rueangchainikhom, W, Promas, S. 50-grams glucose challenge test for screening of gestational diabetes mellitus in high risk pregnancy. J Med Assoc Thai 2007;90:617–23.Search in Google Scholar
© 2022 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Editorial
- A Celebration of Professor Joachim Dudenhausen
- Reviews
- Gestational complications associated with SARS-CoV-2 infection in pregnant women during 2020–2021: systematic review of longitudinal studies
- Eclampsia a preventable tragedy: an African overview
- Original Articles – Obstetrics
- How do bicornuate uteri alter pregnancy, intra-partum and neonatal risks? A population based study of more than three million deliveries and more than 6000 bicornuate uteri
- Maternal urogenital infection and fetal heart functional assessment – what is the missing link?
- Knowledge and attitudes of pregnant women on maternal immunization against COVID-19 in Croatia
- Retrospective review of GCT cutoff value based on pre-pregnancy BMI class in patients with GDM
- Cervical strain elastography: pattern analysis and cervical sliding sign in preterm and control pregnancies
- Maternal race/ethnicity impacts the success rates of external cephalic version (ECV) in the United States
- Fetal adrenal gland size and umbilical artery Doppler in growth-restricted fetuses
- Counseling pregnant women on calcium: effects on calcium intake
- Relationship among anogenital distance, adrenal gland volume, and penile length and width at 22–36 weeks of pregnancy
- Intra-amniotic inflammation in the mid-trimester of pregnancy is a risk factor for neuropsychological disorders in childhood
- Genetic amniocentesis using atraumatic 29 gauge needle in patients having a chorioamniotic separation
- YouTube as a source of patient information on external cephalic version
- Midwives’ personal and professional attitudes towards women’s delivery choices, interventions and neonatal care
- Maternal serum midkine level in fetal growth restriction: a case-control study
- Original Articles – Neonates
- Interventions for reducing late-onset sepsis in neonates: an umbrella review
- Maternal knowledge of recommendations for safe infant sleep and intentions for implementation – a cross sectional analysis of data from the KUNO-Kids birth cohort study
- Short Communication
- Lysophosphatidylcholine acyltransferase 1 protein is present in maternal blood in the third trimester and is upregulated by antenatal corticosteroids
- Letters to the Editor
- Peripartum hysterectomy at a tertiary university perinatal center – retrospective analysis of the 25-year period
- Neonate, infected mother and monkeypox: the present concern
