Gestational diabetes in Singaporean women: use of the glucose challenge test as a screening test and identification of high risk factors.
In this study, 1141 antenatal women attending 9 Government polyclinics were screened between 24 and 28 weeks of gestation for gestational diabetes mellitus (GDM) using the glucose challenge test (GCT). An attempt was made to determine whether 7.2 mmol/l or 7.8 mmol/l was an effective cut-off point as an indicator for GDM. The women with GCT levels of > or = 7.2 mmol/l had an oral glucose tolerance test (OGTT) for confirmation of GDM. The results showed that 420 (36.8%) had GCT levels > or = 7.2 mmol/l, including 299 (26.2%) with GCT levels of > or = 7.8 mmol/l. Of the 190 OGTT carried out, 8 (4.2%) were confirmed to have GDM, all of whom had GCT levels of > or = 7.8 mmol/l, indicating that a GCT level of 7.8 mmol/l was the effective cut-off point. Univariate analysis showed that epidemiological features associated with a raised GCT > or = 7.8 mmol/l were, older age that is 30 years and above, Chinese ethnic group, maternal obesity (body mass index > or = 25) and history of > or = 4 pregnancies. Multivariate analysis using stepwise logistic regression, showed that factors significantly and independently associated with raised GCT levels were older age, Chinese ethnic group and maternal obesity. All antenatal women should be screened for GDM using the GCT, and those with levels of > or = 7.8 mmol/l should be subjected to the OGTT for confirmation.
Ray
R
R
Family Health Service, Primary Health Division, Ministry of Health, Singapore.
Heng
B H
BH
Lim
C
C
Ling
S L
SL
D000328:Adult; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012846:Singapore / Q000453:epidemiology