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Screening for gestational diabetes mellitus in Nigerian pregnant women using fifty-gram oral glucose challenge test.
West Afr J Med 2008; 27(3):139-43WA

Abstract

BACKGROUND

Gestational Diabetes Mellitus (GDM) is frequently associated with adverse pregnancy outcome if not adequately managed. Prompt identification of these women requires a programme of active screening.

OBJECTIVE

To determine the predictive value of the oral 50-gram glucose challenge test (GCT) in the detection of GDM.

METHODS

At 24 to 28 weeks of gestation, 134 pregnant women with risk factors for GDM (test group) and another group of 134 consecutive pregnant women without risk factors for GDM (control group) were screened with 50 grams of anhydrous glucose and venous blood obtained one hour later. A diagnostic 3-hour - 100g oral glucose tolerance test (OGTT) was done for all either within one week for those with GCT > or = 130mg/dl (7.2mmol/L) or at 30 to 32 weeks of gestation for those with GCT of less than 130mg/dll

RESULTS

Of the 134 women in the test group 113 (84.3%) completed the study, as did 109 (81.3%) of the 134 women in the control group. The data from these women were analyzed. Gestational diabetes mellitus was found in 7 (6.2 %) of the test group and 5 (4.6 %) of the control group (p = 0.816), an overall prevalence of 12 (5.4 %) for the study. Among the women with newly diagnosed GDM, 58% had risk factors for glucose intolerance while 42% had no such risk factors. The sensitivity and negative predictive values were all 100% at screening values of 130mg/dl and 140mg/dl; while the specificity was 82.4% at 130mg/dl and 91% at 140mg/dl. This was however not statistically significant (p = 0.619).

CONCLUSION

The plasma glucose value of 140mg/dl in the GCT should be used because of its high sensitivity and higher specificity than does the 130mg/dl screening value. GDM is unlikely to be present if the venous plasma glucose level is less than 140mg/dl, one hour after administration of 50g oral glucose load at 24 to 28 weeks gestational age.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Nigeria. Omololuadegbola@Yahoo.comNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

19256316

Citation

Adegbola, O, and G O. Ajayi. "Screening for Gestational Diabetes Mellitus in Nigerian Pregnant Women Using Fifty-gram Oral Glucose Challenge Test." West African Journal of Medicine, vol. 27, no. 3, 2008, pp. 139-43.
Adegbola O, Ajayi GO. Screening for gestational diabetes mellitus in Nigerian pregnant women using fifty-gram oral glucose challenge test. West Afr J Med. 2008;27(3):139-43.
Adegbola, O., & Ajayi, G. O. (2008). Screening for gestational diabetes mellitus in Nigerian pregnant women using fifty-gram oral glucose challenge test. West African Journal of Medicine, 27(3), pp. 139-43.
Adegbola O, Ajayi GO. Screening for Gestational Diabetes Mellitus in Nigerian Pregnant Women Using Fifty-gram Oral Glucose Challenge Test. West Afr J Med. 2008;27(3):139-43. PubMed PMID: 19256316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for gestational diabetes mellitus in Nigerian pregnant women using fifty-gram oral glucose challenge test. AU - Adegbola,O, AU - Ajayi,G O, PY - 2009/3/5/entrez PY - 2009/3/5/pubmed PY - 2009/3/27/medline SP - 139 EP - 43 JF - West African journal of medicine JO - West Afr J Med VL - 27 IS - 3 N2 - BACKGROUND: Gestational Diabetes Mellitus (GDM) is frequently associated with adverse pregnancy outcome if not adequately managed. Prompt identification of these women requires a programme of active screening. OBJECTIVE: To determine the predictive value of the oral 50-gram glucose challenge test (GCT) in the detection of GDM. METHODS: At 24 to 28 weeks of gestation, 134 pregnant women with risk factors for GDM (test group) and another group of 134 consecutive pregnant women without risk factors for GDM (control group) were screened with 50 grams of anhydrous glucose and venous blood obtained one hour later. A diagnostic 3-hour - 100g oral glucose tolerance test (OGTT) was done for all either within one week for those with GCT > or = 130mg/dl (7.2mmol/L) or at 30 to 32 weeks of gestation for those with GCT of less than 130mg/dll RESULTS: Of the 134 women in the test group 113 (84.3%) completed the study, as did 109 (81.3%) of the 134 women in the control group. The data from these women were analyzed. Gestational diabetes mellitus was found in 7 (6.2 %) of the test group and 5 (4.6 %) of the control group (p = 0.816), an overall prevalence of 12 (5.4 %) for the study. Among the women with newly diagnosed GDM, 58% had risk factors for glucose intolerance while 42% had no such risk factors. The sensitivity and negative predictive values were all 100% at screening values of 130mg/dl and 140mg/dl; while the specificity was 82.4% at 130mg/dl and 91% at 140mg/dl. This was however not statistically significant (p = 0.619). CONCLUSION: The plasma glucose value of 140mg/dl in the GCT should be used because of its high sensitivity and higher specificity than does the 130mg/dl screening value. GDM is unlikely to be present if the venous plasma glucose level is less than 140mg/dl, one hour after administration of 50g oral glucose load at 24 to 28 weeks gestational age. SN - 0189-160X UR - https://www.unboundmedicine.com/medline/citation/19256316/Screening_for_gestational_diabetes_mellitus_in_Nigerian_pregnant_women_using_fifty_gram_oral_glucose_challenge_test_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -