Beschreibung:
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<jats:title>INTRODUCTION:</jats:title>
<jats:p>Cutoff values for the one-hour, 50-g glucose test (Glucola) in early pregnancy are based on data from studies at 24-28 weeks. A value of 200 mg/dL is often used to give a diagnosis of GDM without further testing. The aim of this study was to establish a lower cutoff for the early Glucola over which women should receive an immediate diagnosis of GDM.</jats:p>
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<jats:title>METHODS:</jats:title>
<jats:p>In this IRB-approved retrospective cohort study, the electronic medical records in the Geisinger system were searched between 1/1/2010 and 12/31/2016 for all women who had completed a Glucola prior to 20 weeks and all subsequent indicated testing. Women with a result of 130-199 mg/dL on the early Glucola went on to complete a three-hour 100-g glucose tolerance test. Women who were not diagnosed with GDM on early screening underwent routine screening after 24 weeks. The risk of developing GDM for a given early Glucola result was analyzed to identify another, potentially lower level, above which women should receive an immediate diagnosis of GDM without further testing.</jats:p>
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<jats:title>RESULTS:</jats:title>
<jats:p>There were 3040 women identified as having completed an early Glucola and 631 women had a result between 130 and 199 mg/dL. 125 women were diagnosed with GDM at some point in the pregnancy. Increasing values for the early Glucola trended towards higher positive predictive values as would be expected. However, the positive predictive value never surpassed 32.4%.</jats:p>
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<jats:title>CONCLUSION:</jats:title>
<jats:p>A change in practice where a lower glucose level is used to diagnose GDM from the early Glucola is currently not supported.</jats:p>
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