First Trimester Fasting Blood Sugar Level As a Predictor of Abnormal Results on Glucose Tolerance Test at 24 to 28 Weeks of Gestation



Mirzamoradi M¹ ; Salehi S² ; Shahabi V³ ; Borumandnia N⁴ ; Jamali R⁵ ; Jamali M⁵
Source: Perinatology Published:2021

Abstract

Background: Gestational diabetes mellitus (GDM) results in both maternal and fetal complications. All pregnant women should be screened for GDM. Glucose tolerance test (GTT) is the test of choice; however, it has several disadvantages. Aim: To evaluate the ability of the first trimester fasting blood sugar (FBS) level to predict abnormal results on GTT at 24 to 28 weeks of gestation Materials and Methods: In this retrospective study, 900 consecutive pregnant women in their first trimester, between 2017 to 2019, were enrolled. The χ2 test, independent samples t test, and receiver operating characteristic (ROC) curve were used for analyses. Results: Among the 900 pregnant women, 364 (40.4%) had first trimester FBS level ≥ 92 mg/dL, and the remaining 536 (59.6%) had normal FBS. When the GTT was performed, among the 536 women with normal FBS level, 148 (27.6%) had at least one abnormal value, whereas 388 (72.4%) had negative results on the GTT. The ROC curve was used to determine the appropriate cutoff value for FBS to predict GDM. The most optimal FBS level is 82.5 mg/dL, with 62.2% sensitivity and 45.1% specificity. Conclusion: The results of this study demonstrate that the sensitivity and specificity of FBS level for the screening of GDM in the Iranian population is similar to those of the international guidelines, and new cutoff points are not sufficiently applicable for this population. © 2021, Himalaya Wellness Company. All rights reserved.