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document
Prediction of gestational diabetes mellitus in the first trimester , comparison of fasting plasma glucose , two-step and one-step methods : a prospective randomized controlled trial . Our aim was to evaluate and compare the diagnostic performance of three methods commonly used for GDM screening : fasting plasma glucose ( FPG ) , two-step 50 g glucose challenge test ( GCT ) , and 75 g glucose tolerance test ( GTT ) in a randomized study design to predict GDM in the first trimester and determine the best approach in predicting GDM . In a non-blind , parallel-group prospective randomized controlled study ; 736 singleton pregnant women underwent FPG testing in the first trimester and randomly assigned to two groups ; two-step 50 g GCT and 75 g GTT . GDM diagnosis was made according to Carpenter-Coustan or ADA ( American Diabetes Association ) criteria in two-step 50 g GCT and 75 g GTT groups , respectively . Subsequent testing was performed by two-step 50 g GCT at 24-28 weeks for screen negatives . After excluding the women who were lost to follow-up or withdrawn as a result of pregnancy loss , 486 pregnant women were recruited in the study . The FPG , two-step GCT , and one-step GTT methods identified GDM in 25/486 ( 5.1 % ) , 15/248 ( 6.0 % ) , and 27/238 ( 11.3 % ) women , respectively . Area under ROC curves were 0.623 , 0.708 , and 0.792 , respectively . Sensitivities were 47.17 , 68.18 , and 87.1 % , respectively . Specificities were 77.37 , 100 , and 100 % , respectively . Positive predictive values were 20.33 , 100 , and 100 % , respectively . Negative predictive values were 92.29 , 97 , and 98.1 % , respectively . Until superior screening alternatives become available , the 75 g GTT may be preferred for GDM screening in the first trimester .
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Intervention_Pharmacological
fasting plasma glucose ( FPG )
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Intervention_Pharmacological
glucose challenge test ( GCT )
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Intervention_Pharmacological
75 g glucose tolerance test ( GTT )
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Intervention_Pharmacological
two-step 50 g GCT
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Intervention_Pharmacological
75 g GTT
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Outcome_Other
diagnostic performance
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Outcome_Other
Area under ROC curves
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Outcome_Other
Sensitivities
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Outcome_Other
Positive predictive values
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Outcome_Other
Negative predictive values
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Participant_Condition
first trimester
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Participant_Condition
first trimester
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Participant_Sample-size
736
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Participant_Sex
women
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Participant_Sample-size
486
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Participant_Sex
women
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Participant_Sex
women
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Participant_Condition
first trimester