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Related Experiment Videos

Postpartum testing for antecedent gestational diabetes.

M W Carpenter1, D R Coustan, J A Widness

  • 1Department of Obstetrics and Gynecology, Brown University Program in Medicine, Providence, RI.

American Journal of Obstetrics and Gynecology
|November 1, 1988
PubMed
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A postpartum oral glucose tolerance test effectively identifies women with prior gestational diabetes. This test offers high sensitivity and specificity for detecting glucose intolerance, aiding in early diagnosis and management.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Clinical Diagnostics

Background:

  • Gestational diabetes mellitus (GDM) predicts future glucose intolerance in women and their offspring.
  • Many women with GDM are not diagnosed, despite signs of hyperglycemia.
  • Early detection of GDM is crucial for maternal and infant health.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of a postpartum oral glucose tolerance test (oGTT) for detecting antecedent gestational diabetes.
  • To compare the utility of postpartum oGTT with cord plasma glucose, cord plasma C-peptide, and neonatal glucose levels.

Main Methods:

  • A postpartum (within 48 hours) 100 gm oGTT was administered to women with (n=37) and without (n=28) documented GDM.
  • Cord plasma glucose, cord plasma C-peptide, and 2-hour neonatal plasma glucose were measured.

Related Experiment Videos

  • Receiver operating characteristic (ROC) curve analysis was used to assess diagnostic performance.

    • Main Results:

    • Postpartum oGTT 1-hour, 2-hour, and incremental glucose values showed significant differences between women with and without GDM (p < 0.025).
    • Maternal fasting/3-hour glucose, cord plasma glucose/C-peptide, and neonatal glucose did not differ significantly between groups.
    • The incremental 1-hour + 2-hour postpartum oGTT demonstrated the best balance of sensitivity and specificity.

    Conclusions:

    • The incremental 1-hour + 2-hour postpartum oGTT is a valuable tool for identifying women with previous gestational diabetes.
    • A threshold of 110 mg/dl for this test achieved 90% specificity and 80% sensitivity.
    • This postpartum test can aid in identifying women at risk for future glucose intolerance.