Intrapartum screen for diabetes in patients without prenatal care: use of labor admission serum glucose.
OBJECTIVE
For patients presenting in labor with no prenatal care, a rapid screening test for gestational diabetes would potentially aid in decisions for tocolysis (e.g., preterm patients) and mode of delivery (e.g., large for gestational age). We sought to determine whether a labor admission serum glucose is of predictive value in the diagnosis of gestational diabetes.


METHODS
We obtained labor admission glucose values for laboring patients and compared these with 1-h (50-g) postglucola (1 degree PG) screens obtained at 24 to 32 weeks' gestation. Diabetics being treated with insulin were excluded from the study. Labor admission serum glucose values were compared to 1 degrees PG values by linear regression. Sensitivity and specificity of admission glucose for identification of a positive 1 degree PG (140 mg/dl) were evaluated by a receiver operator curve (ROC).


RESULTS
A total of 98 patients with both 1 degree PG screens and labor admission glucose were identified. Linear regression showed no significant correlation of labor admission glucose and 1 degree PG values (r = 0.13; P = 0.9). The ROC failed to demonstrate an optimal admission random glucose cutoff value for diagnosis of diabetes.


CONCLUSIONS
In laboring patients without insulin-requiring diabetes, labor admission glucose does not predict an abnormal 1 degree PG and thus does not aid in labor management of patients with suboptimal prenatal care.
Grover
J
J
Department of Obstetrics and Gynecology, Harbor UCLA Medical Center, Torrance, California 90509, USA.
Beall
M H
MH
Ross
M G
MG
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D050260:Carbohydrate Metabolism; D002241:Carbohydrates; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008499:Medical Records; D010343:Patient Admission; D011237:Predictive Value of Tests; D011247:Pregnancy; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000592:standards*; D012189:Retrospective Studies
D001786:Blood Glucose; D002241:Carbohydrates; C007853:Glucola