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Fasting plasma glucose test at the first prenatal visit as a screen for gestational diabetes
David A Sacks1, Wansu Chen, Girma Wolde-Tsadik
1Department of Obstetrics and Gynecology, Kaiser Foundation Hospital, Bellflower, California 90740, USA. david.a.sacks@kp.org
Objective:
To determine whether the fasting plasma glucose test administered at the first prenatal visit could serve as an efficient screen for gestational diabetes.
Methods:
A total of 5557 women not known to have diabetes were offered a fasting plasma glucose test at their first prenatal visit. Results less than 100 mg/dL were blinded. A glucose tolerance test was requested immediately of those whose screening test result was 100-125 mg/dL and of all women not identified as having diabetes by their 23rd gestational week.
Results:
A total of 4507 women (81%) complied with the protocol. Of the 302 women found to have gestational diabetes, 46 (15%) were detected before 24 weeks. A false-positive rate of 57% was found at a threshold fasting glucose concentration giving a sensitivity of 80% for the detection of gestational diabetes.
Conclusion:
The fasting plasma glucose screening test at the first prenatal visit has good patient compliance. However, its poor specificity (high false-positive rate) makes it an inefficient screening test for gestational diabetes.
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