Article Text
PDF
Abstract
Objective To evaluate fasting plasma glucose (FPG) as a screening test for gestational diabetes mellitus (GDM) among Mexican adolescents using International Association of Diabetes and Pregnancy Study Groups criteria.
Design Retrospective cohort study.
Setting Level-three medical institution in Mexico City.
Participants The study population comprised 1061 adolescent women aged 12–19 years with singleton pregnancies, who underwent a 75 g oral glucose tolerance test (OGTT) between 11 and 35 weeks of gestation.
Primary and secondary outcome measures The sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV and NPV, respectively), and positive and negative likelihood ratios LR (+) and LR (−), respectively) with 95% CIs for selected FPG cut-off values were compared. Secondary measures were perinatal outcomes in women with and without GDM.
Results GDM was present in 71 women (6.7%, 95% CI 5.3% to 8.4%). The performances of FPG at thresholds of ≥80 (4.5 mmol/L), 85 (4.7 mmol/L) and 90 mg/dL (5.0 mmol/L) were as follow (95% CI): Sn: 97% (89% to 99%), 94% (86% to 97%) and 91% (82% to 95%); Sp: 50% (47% to 53%), 79% (76% to 81%) and 97% (95% to 97%); PPV: 12% (9% to 15%), 23% (18% to 28%) and 64% (54% to 73%); NPV: 99% (98.5% to 99.9%) for all three cut-offs; LR (+): 1.9 (1.8 to 2.1), 4.3 (3.8 to 5.0) and 26.7 (18.8 to 37.1) and LR (−): 0.06 (0.02 to 0.23), 0.07 (0.03 to 0.19) and 0.09 (0.04 to 0.19), respectively. No significant differences in perinatal outcomes were found between adolescents with and without GDM.
Conclusions An FPG cut-off of ≥90 mg/dL (5.0 mmol/L) is ideal for GDM screening in Mexican adolescent women. An FPG threshold of 90 mg/dL would miss 6 (8.5%) women with GDM, pick up 34 (3.4%) women without GDM and avoid 962 (90.7%) OGTTs.
- gestational diabetes
- IADPSG
- hyperglycaemia
- pregnancy
- adolescent
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Contributors ER-M, NLS-O and JL-P conceived and designed the study, analysed the data and wrote the paper. NM-C, LA-S, CO-G and GE-G analysed the data and reviewed the paper. NLS-O, CR-M, MAR-T and AM-E acquired the data, interpreted the results and reviewed the paper.
Funding This work was supported by National Council of Science and Technology, CONACYT, Mexico (Grant no. 233634) and Instituto National de Perinatología Isidro Espinosa de los Reyes, Mexico City (Registry ID: 212250-3402-10102-02-14).
Competing interests None declared.
Patient consent Not required.
Ethics approval The study was approved by the Ethics and Research Internal Review Board of the Instituto Nacional de Perinatología in Mexico City (register number: 212250-3402-10102-02-14).
Provenance and peer review Not commissioned; externally peer reviewed.