title: The prognostic value of a normal oral glucose tolerance test in pregnant women who tested positive at screening: a validation study.
abstract: BACKGROUND
  Controversies surround a diagnosis of gestational diabetes mellitus (GDM). The objective of this study was to evaluate the oral glucose tolerance test (OGTT) for the prediction of adverse gestational and perinatal outcomes in pregnant women with a positive screening test for diabetes mellitus and a negative diagnosis, i.e. a normal 3-hour OGTT.
  
  
  METHODS
  This validation study evaluated 409 pregnant women who tested positive for diabetes mellitus at screening. Perinatal and maternal outcomes were considered. Sensitivity and specificity were calculated for each of the values of the OGTT as a diagnostic test, with the gold standard being perinatal outcome.
  
  
  RESULTS
  The most frequent risk factors were obesity, arterial hypertension and advanced maternal age. The most common neonatal outcomes were large-for-gestational-age infants, Cesarean delivery and preterm birth. A fasting blood glucose level of 87 mg/dL was the most powerful predictor of adverse perinatal outcome.
  
  
  CONCLUSIONS
  At the cut-off level adopted by the American Diabetes Association, gestational OGTT was able to successfully identify in which pregnant women outcome would be unfavorable.
authors.affiliation: School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil. pm.rehder@uol.com.br.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Rehder
authors.forename: Belmiro G
authors.initials: BG
authors.lastname: Pereira
authors.forename: João Luiz Pinto
authors.initials: JL
authors.lastname: E Silva