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- Title
Screening Accuracy of the 50 g-Glucose Challenge Test in Twin Compared With Singleton Pregnancies.
- Authors
Hiersch, Liran; Shah, Baiju R.; Berger, Howard; Geary, Michael; McDonald, Sarah D.; Murray-Davis, Beth; Jun Guan; Halperin, Ilana; Retnakaran, Ravi; Barrett, Jon; Melamed, Nir
- Abstract
Context: The optimal 50 g-glucose challenge test (GCT) cutoff for the diagnosis of gestational diabetes mellitus (GDM) in twin pregnancies is unknown. Objective: This work aimed to explore the screening accuracy of the 50 g-GCT and its correlation with the risk of large for gestational age (LGA) newborn in twin compared to singleton pregnancies. A population-based retrospective cohort study (2007-2017) was conducted in Ontario, Canada. Participants included patients with a singleton (n = 546 892 [98.4%]) or twin (n = 8832 [1.6%]) birth who underwent screening for GDM using the 50 g-GCT. Methods: We compared the screening accuracy, risk of GDM, and risk of LGA between twin and singleton pregnancies using various 50 g-GCT cutoffs. Results: For any given 50 g-GCT result, the probability of GDM was higher (P = .0.007), whereas the probability of LGA was considerably lower in the twin compared with the singleton group, even when a twin-specific growth chart was used to diagnose LGA in the twin group (P < .001). The estimated false-positive rate (FPR) for GDM was higher in twin compared with singleton pregnancies irrespective of the 50 g-GCT cutoff used. The cutoff of 8.2 mmol/L (148 mg/dL) in twin pregnancies was associated with an estimated FPR (10.7%-11.1%) that was similar to the FPR associated with the cutoff of 7.8 mmol/L (140 mg/dL) in singleton pregnancies (10.8%). Conclusion: The screening performance of the 50 g-GCT for GDM and its correlation with LGA differ between twin and singleton pregnancies.
- Subjects
GESTATIONAL diabetes; PREGNANCY; GESTATIONAL age; BLOOD sugar monitoring; TWINS
- Publication
Journal of Clinical Endocrinology & Metabolism, 2022, Vol 107, Issue 10, p2854
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/clinem/dgac472