Fasting plasma glucose test at the first prenatal visit as a screen for gestational diabetes.
OBJECTIVE
To determine whether the fasting plasma glucose test administered at the first prenatal visit could serve as an efficient screen for gestational diabetes.


METHODS
A total of 5557 women not known to have diabetes were offered a fasting plasma glucose test at their first prenatal visit. Results less than 100 mg/dL were blinded. A glucose tolerance test was requested immediately of those whose screening test result was 100-125 mg/dL and of all women not identified as having diabetes by their 23rd gestational week.


RESULTS
A total of 4507 women (81%) complied with the protocol. Of the 302 women found to have gestational diabetes, 46 (15%) were detected before 24 weeks. A false-positive rate of 57% was found at a threshold fasting glucose concentration giving a sensitivity of 80% for the detection of gestational diabetes.


CONCLUSIONS
The fasting plasma glucose screening test at the first prenatal visit has good patient compliance. However, its poor specificity (high false-positive rate) makes it an inefficient screening test for gestational diabetes.
Sacks
David A
DA
Department of Obstetrics and Gynecology, Kaiser Foundation Hospital, Bellflower, California 90740, USA. david.a.sacks@kp.org
Chen
Wansu
W
Wolde-Tsadik
Girma
G
Buchanan
Thomas A
TA
D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005189:False Positive Reactions; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening; D011247:Pregnancy; D011295:Prenatal Care; D012372:ROC Curve; D012680:Sensitivity and Specificity