%0 Journal Article
%T The prognostic value of a normal oral glucose tolerance test in pregnant women who tested positive at screening: a validation study
%A Patricia M Rehder
%A Belmiro G Pereira
%A Jo£żo e Silva
%J Diabetology & Metabolic Syndrome
%D 2012
%I BioMed Central
%R 10.1186/1758-5996-4-10
%X This validation study evaluated 409 pregnant women who tested positive for diabetes mellitus at screening. Perinatal and maternal outcomes were considered. Sensitivity and specificity were calculated for each of the values of the OGTT as a diagnostic test, with the gold standard being perinatal outcome.The most frequent risk factors were obesity, arterial hypertension and advanced maternal age. The most common neonatal outcomes were large-for-gestational-age infants, Cesarean delivery and preterm birth. A fasting blood glucose level of 87 mg/dL was the most powerful predictor of adverse perinatal outcome.At the cut-off level adopted by the American Diabetes Association, gestational OGTT was able to successfully identify in which pregnant women outcome would be unfavorable.Many controversies surround the diagnosis of gestational diabetes mellitus (GDM). In 1998, the American Diabetes Association (ADA) recommended the adoption of an oral glucose tolerance test (OGTT) using 100 or 75 g of dextrosol with well-defined cut-off limits for glucose levels at fasting and following a glucose overload: fasting < 95 mg/dL; 1 h < 180 mg/dL; 2 h < 155 mg/dL; and 3 h < 140 mg/dL [1]. GDM is diagnosed when two or more values are found to be above the established cut-off limits. These recommendations were based on studies conducted by O'Sullivan and Mahan, published in 1964 [2] and adapted by Carpenter and Coustan in 1982 [3]. They have been maintained for the past 10 years [4].The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommended the adoption of certain markers for screening. If one of these markers is present, an oral glucose tolerance test is then performed. According to the guidelines proposed by IADPSG, only one value above the cut-off limit in the 3-hour OGTT is sufficient to justify a diagnosis of GDM. If applied, this criterion will lead to a diagnosis of GDM in 18-20% of the entire obstetric population [5].In parallel, a diabetes study gro
%K Gestational diabetes mellitus
%K Risk factors for gestational diabetes mellitus
%K Perinatal
%K Outcomes in gestational diabetes mellitus
%K Prenatal care
%U http://www.dmsjournal.com/content/4/1/10