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Comparison of the performance of screening test for gestational diabetes in singleton versus twin pregnancies.

Jung YJ, Kwon JY, Cho HY, Park YW, Kim YH - Obstet Gynecol Sci (2015)

Bottom Line: GCT results were available in 3,578 pregnancies (3,435 singleton and 143 twin pregnancies).The false positive rate for GCT ≥140 mg/dL was significantly higher in the twin than in the singleton group (P=0.042).Our study demonstrates that the GCT is associated with a higher false positive rate in twin rather than singleton pregnancies.

View Article: PubMed Central - PubMed

Affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: We compared the performance of the 50-g glucose challenge test (GCT) in singleton versus twin pregnancies and investigated the need for adjusting GCT cutoff values for gestational diabetes mellitus (GDM) in twin pregnancies among Korean women.

Methods: A retrospective chart review was performed in women who underwent GCT at 24 to 28 weeks' gestation and delivered in our department between January 2000 and April 2008. GCT performance was compared between singleton and twin pregnancies for an ideal cutoff value of the GCT for GDM screening.

Results: GCT results were available in 3,578 pregnancies (3,435 singleton and 143 twin pregnancies). The mean GCT value was higher in the twin group than in the singleton group. Women in the twin group had a higher mean GCT value (P=0.043) and a higher incidence of GCT ≥130, ≥135, and ≥140 mg/dL (P=0.014, 0.005, and 0.015, respectively). The false positive rate for GCT ≥140 mg/dL was significantly higher in the twin than in the singleton group (P=0.042). The optimal GCT screening cutoff value appears to be ≥145 mg/dL in twin pregnancies.

Conclusion: Our study demonstrates that the GCT is associated with a higher false positive rate in twin rather than singleton pregnancies. This study suggests we should consider adjusting the GCT cutoff value for GDM in Korean twin pregnancies.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristic curve for glucose challenge test in twin pregnancies. This receiver operating characteristic shows the sensitivity and 1-specificity of diagnosis of gestational diabetes mellitus for all patients with twin pregnancies undergoing glucose challenge test.
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Figure 2: Receiver operating characteristic curve for glucose challenge test in twin pregnancies. This receiver operating characteristic shows the sensitivity and 1-specificity of diagnosis of gestational diabetes mellitus for all patients with twin pregnancies undergoing glucose challenge test.

Mentions: The diagnostic characteristics of the GCT based on the different cutoffs are shown in Table 3. All three GCT cutoffs in twin pregnancies had a high sensitivity. A GCT cutoff of ≥140 mg/dL had a higher specificity and had lower false positive rate for GCT. The receiver operating characteristic (ROC) curve considering singleton pregnancies is shown in Fig. 1. The area under ROC curve of GCT was 0.920 (95% confidence interval, 0.898 to 0.943; P<0.001). It was observed that a GCT cutoff value ≥139 mg/dL had a sensitivity of 87.1% and specificity of 86.3% in diagnosing GDM. The ROC curve reflecting twin pregnancies is shown in Fig. 2. The area under ROC curve of GCT in twin pregnancies was 0.958 (95% confidence interval, 0.917 to 0.999; P<0.001). It was observed that a GCT cutoff value ≥145 mg/dL had a sensitivity of 88.9% and specificity of 86.3% in diagnosing GDM.


Comparison of the performance of screening test for gestational diabetes in singleton versus twin pregnancies.

Jung YJ, Kwon JY, Cho HY, Park YW, Kim YH - Obstet Gynecol Sci (2015)

Receiver operating characteristic curve for glucose challenge test in twin pregnancies. This receiver operating characteristic shows the sensitivity and 1-specificity of diagnosis of gestational diabetes mellitus for all patients with twin pregnancies undergoing glucose challenge test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663220&req=5

Figure 2: Receiver operating characteristic curve for glucose challenge test in twin pregnancies. This receiver operating characteristic shows the sensitivity and 1-specificity of diagnosis of gestational diabetes mellitus for all patients with twin pregnancies undergoing glucose challenge test.
Mentions: The diagnostic characteristics of the GCT based on the different cutoffs are shown in Table 3. All three GCT cutoffs in twin pregnancies had a high sensitivity. A GCT cutoff of ≥140 mg/dL had a higher specificity and had lower false positive rate for GCT. The receiver operating characteristic (ROC) curve considering singleton pregnancies is shown in Fig. 1. The area under ROC curve of GCT was 0.920 (95% confidence interval, 0.898 to 0.943; P<0.001). It was observed that a GCT cutoff value ≥139 mg/dL had a sensitivity of 87.1% and specificity of 86.3% in diagnosing GDM. The ROC curve reflecting twin pregnancies is shown in Fig. 2. The area under ROC curve of GCT in twin pregnancies was 0.958 (95% confidence interval, 0.917 to 0.999; P<0.001). It was observed that a GCT cutoff value ≥145 mg/dL had a sensitivity of 88.9% and specificity of 86.3% in diagnosing GDM.

Bottom Line: GCT results were available in 3,578 pregnancies (3,435 singleton and 143 twin pregnancies).The false positive rate for GCT ≥140 mg/dL was significantly higher in the twin than in the singleton group (P=0.042).Our study demonstrates that the GCT is associated with a higher false positive rate in twin rather than singleton pregnancies.

View Article: PubMed Central - PubMed

Affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: We compared the performance of the 50-g glucose challenge test (GCT) in singleton versus twin pregnancies and investigated the need for adjusting GCT cutoff values for gestational diabetes mellitus (GDM) in twin pregnancies among Korean women.

Methods: A retrospective chart review was performed in women who underwent GCT at 24 to 28 weeks' gestation and delivered in our department between January 2000 and April 2008. GCT performance was compared between singleton and twin pregnancies for an ideal cutoff value of the GCT for GDM screening.

Results: GCT results were available in 3,578 pregnancies (3,435 singleton and 143 twin pregnancies). The mean GCT value was higher in the twin group than in the singleton group. Women in the twin group had a higher mean GCT value (P=0.043) and a higher incidence of GCT ≥130, ≥135, and ≥140 mg/dL (P=0.014, 0.005, and 0.015, respectively). The false positive rate for GCT ≥140 mg/dL was significantly higher in the twin than in the singleton group (P=0.042). The optimal GCT screening cutoff value appears to be ≥145 mg/dL in twin pregnancies.

Conclusion: Our study demonstrates that the GCT is associated with a higher false positive rate in twin rather than singleton pregnancies. This study suggests we should consider adjusting the GCT cutoff value for GDM in Korean twin pregnancies.

No MeSH data available.


Related in: MedlinePlus