caa a22 4500 378904698 CHVBK 20180305123527.0 cr unu---uuuuu 161128e20040901xx s 000 0 eng 10.1515/CCLM.2004.209 doi (NATIONALLICENCE)gruyter-10.1515/CCLM.2004.209 The clinical impact of screening for gestational diabetes [Elektronische Daten] [Tine Schytte, Lone G. M. Jørgensen, Ivan Brandslund, Per Hyltoft Petersen, Bent Andersen] Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance during pregnancy. In Denmark the health service offers selective screening for GDM, i.e., admission to an oral glucose tolerance test (OGTT) after pre-screening with interview for clinical risk factors for GDM, two capillary fasting blood glucose (cFBG) measurements and a urine test for glucosuria. The aim of the present study was to investigate the power of the pre-screening to identify GDM and the screening to predict adverse clinical outcome. A retrospective investigation of pregnant women undergoing screening during 1998 at Vejle County Hospital, Denmark was undertaken. The two most frequent pre-screening criteria for OGTT were body-mass index (BMI) ≥ 27 kg/m2 and age ≥ 35 years. The highest odds ratio (OR) of 9.07 (95% CI: 2.60 to 63.70) for GDM had glucosuria and the lowest (zero) had cFBG. The frequency of complicated delivery was similar in GDM (58%) compared to non-GDM (56%). The best predictor of complicated delivery was a BMI with OR=1.50 (95% CI: 0.87 to 2.60) for BMI ≥ 27 kg/m2 vs. < 27 kg/m2. The best predictor of adverse neonatal outcome was a capillary blood glucose 120 min after glucose load (cBG120 min) ≥9.0 mmol/l (OR=3.18, 95% CI: 1.14 to 8.89). The intermediary endpoint GDM was not superior for predicting adverse maternal and neonatal outcome. The cumulative probability distribution of cBG120 min after a 75 g glucose load was not homogeneously distributed in groups stratified according to maternal and foetal outcome. A changed slope was seen after cBG120 min 9.0 mmol/l. Screening cFBG of 4.1 mmol/l was unable to predict GDM and adverse outcome. Glucosuria was too rare to be effective as a screening tool. Pre-screening did not identify GDM. The best predictor of complicated delivery was a high BMI. The best predictor of foetal adverse outcome was cBG120 min ≥ 9.0 mmol/l after a 75 g glucose load. Identical fraction complications were present in GDM and non-GDM. A refinement of the screening procedure is highly needed, and this has been initiated in Denmark. © Walter de Gruyter Medical equipment & techniques nationallicence Medical diagnosis nationallicence Diseases & disorders nationallicence gestational diabetes nationallicence pregnancy nationallicence screening nationallicence Schytte Tine The Laboratory Centre, Vejle County Hospital, Vejle, Denmark aut Jørgensen Lone G. M. The Laboratory Centre, Vejle County Hospital, Vejle, Denmark aut Brandslund Ivan The Laboratory Centre, Vejle County Hospital, Vejle, Denmark aut Petersen Per Hyltoft Department of Clinical Chemistry, Odense University Hospital, Odense, Denmark and Norwegian Centre for external quality assurance of primary care laboratories, University of Bergen, Norway aut Andersen Bent Department of Gynecology and Obstetrics, Vejle County Hospital, Vejle, Denmark aut Clinical Chemistry and Laboratory Medicine Walter de Gruyter 42/9(2004-09-01), 1036-1042 1434-6621 42:9<1036 2004 42 cclm https://doi.org/10.1515/CCLM.2004.209 text/html Onlinezugriff via DOI 1 research article jats NATIONALLICENCE 856 40 https://doi.org/10.1515/CCLM.2004.209 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schytte Tine The Laboratory Centre, Vejle County Hospital, Vejle, Denmark aut NATIONALLICENCE 700 1- Jørgensen Lone G. M. The Laboratory Centre, Vejle County Hospital, Vejle, Denmark aut NATIONALLICENCE 700 1- Brandslund Ivan The Laboratory Centre, Vejle County Hospital, Vejle, Denmark aut NATIONALLICENCE 700 1- Petersen Per Hyltoft Department of Clinical Chemistry, Odense University Hospital, Odense, Denmark and Norwegian Centre for external quality assurance of primary care laboratories, University of Bergen, Norway aut NATIONALLICENCE 700 1- Andersen Bent Department of Gynecology and Obstetrics, Vejle County Hospital, Vejle, Denmark aut NATIONALLICENCE 773 0- Clinical Chemistry and Laboratory Medicine Walter de Gruyter 42/9(2004-09-01), 1036-1042 1434-6621 42:9<1036 2004 42 cclm CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-gruyter