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Glycohemoglobin as a screening test for gestational diabetes
American Journal of Obstetrics and Gynecology
|February 15, 1984
Summary
Hemoglobin A1c is not a reliable screening test for gestational diabetes. While it correlates with glucose tolerance tests, high false positive and negative rates make it inadequate for diagnosing this pregnancy complication.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Clinical Chemistry
Background:
- Gestational diabetes mellitus (GDM) poses risks to both mother and fetus.
- Accurate and efficient screening methods for GDM are crucial for timely intervention.
- Hemoglobin A1c (HbA1c) has been proposed as a potential screening tool due to its reflection of average blood glucose levels.
Purpose of the Study:
- To evaluate the feasibility and accuracy of using hemoglobin A1c as a screening test for gestational diabetes.
- To compare the diagnostic performance of HbA1c against the standard oral glucose tolerance test (OGTT).
Main Methods:
- A cohort of 82 pregnant women in their third trimester were enrolled.
- Hemoglobin A1c levels were measured and compared to results from a 100 gm oral glucose tolerance test.
Main Results:
- At the optimal correlation threshold (HbA1c of 7%), the agreement between HbA1c and OGTT was 69%.
- The screening demonstrated a high false-positive rate of 41% and a false-negative rate of 26%.
Conclusions:
- Despite a good correlation, the significant rates of false positives and negatives render hemoglobin A1c inadequate for screening gestational diabetes.
- Current screening protocols relying on OGTT remain the standard of care for gestational diabetes detection.