Proportion of abnormal second 50‐g glucose challenge test in gestational diabetes mellitus screening using the two‐step method in high‐risk pregnant women

Abstract

Aims:To determine the merit of repeating 50-g glucose challenge test (50-g GCT) at 24-28 weeks of gestation in high-risk pregnant women and the prevalence of early-and late-onset gestational diabetes mellitus (GDM). Methods: This study was conducted in 1447 pregnant women, 344 of them were at risks for GDM undergoing screening by two-step method at first visit. Data were not completely collected in 47 women leaving only 297 for analyses. Fifty-six of 297 pregnant women were diagnosed as early-onset GDM (18.8%) and the other 241 pregnant women were consequently screened at 24-28 weeks of gestation to identify late-onset GDM. Screening data were retrieved, including risks, laboratory test results, baseline characteristics and diagnostic outcomes. Proportion of abnormal second 50-g GCT and the prevalence of late-onset GDM were estimated. Results: The prevalence of late-onset GDM was 17.8%. Among groups of normal 50-g GCT, abnormal 50-g GCT and abnormal 1 oral glucose tolerance test (OGTT) value at first test, the proportions of abnormal 50-g GCT at second test were 38.3%, 59.5% and 79.3%, and the prevalence of late-onset GDM among each group were 18.8%, 8.3% and 41.4%, consecutively. This lead to prevalence of GDM in this high-risk group of 33.3% and overall among 1447 women was 7.9%. Conclusion: There were high proportions of abnormal 50-g GCT at second test in the groups with abnormal 50-g GCT and abnormal 1 OGTT value at first test (59.5% and 79.3%). Authors suggested doing OGTT without repeating 50-g GCT in these groups coming at 24-28 weeks of gestation.

Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors

“…A large retrospective cohort study in Portugal including 18,518 pregnant women with GDM reported that the incidence of earlyonset GDM (≤12 weeks) was 34.4% according to the IADPSG diagnostic criteria; there was no difference in the incidence of PE between women with early-and later-onset GDM (74). Furthermore, several studies have reported the same conclusion (55, [75][76][77][78][79]. In early-onset GDM, metformin or insulin treatment is more needed (75,78,79), it is uncertain whether it will affect the occurrence of PE.…”

“…Furthermore, several studies have reported the same conclusion ( 55 , 75 – 79 ). In early-onset GDM, metformin or insulin treatment is more needed ( 75 , 78 , 79 ), it is uncertain whether it will affect the occurrence of PE. However, women with early-onset GDM have more risk factors for PE, such as older age, multiple pregnancy, and higher pre pregnancy BMI ( 80 , 81 ).…”

A model for predicting gestational diabetes mellitus in early pregnancy: a prospective study in Thailand

“…From a systematic review of diagnostic test accuracy studies in Southeast Asia, the prevalence of GDM screened using a two-step approach at 24–28 weeks ranged from 7.1% to 28.6% in Thailand [ 37 ]. Two retrospective studies were published in 2020 [ 38 ] and 2021 [ 16 ], which showed the rates of early onset GDM at 18.9% and 9.2%, respectively. The variation in the reported early GDM rate depends on universal screening or screening in high-risk pregnant women.…”