title: Single Fasting Plasma Glucose Versus 75-g Oral Glucose-Tolerance Test in Prediction of Adverse Perinatal Outcomes: A Cohort Study.
abstract: BACKGROUND
  There remains uncertainty regarding whether a single fasting glucose measurement is sufficient to predict risk of adverse perinatal outcomes.
  
  
  METHODS
  We included 12,594 pregnant women who underwent a 75-g oral glucose-tolerance test (OGTT) at 22-28weeks' gestation in the Born in Guangzhou Cohort Study, China. Outcomes were large for gestational age (LGA) baby, cesarean section, and spontaneous preterm birth. We calculated the area under the receiver operator characteristic curves (AUCs) to assess the capacity of OGTT glucose values to predict adverse outcomes, and compared the AUCs of different components of OGTT.
  
  
  RESULTS
  1325 women had a LGA baby (10.5%). Glucose measurements were linearly associated with LGA, with strongest associations for fasting glucose (odds ratio 1.37, 95% confidence interval 1.30-1.45). Weaker associations were observed for cesarean section and spontaneous preterm birth. Fasting glucose have a comparable discriminative power for prediction of LGA to the combination of fasting, 1h, and 2h glucose values during OGTT (AUCs, 0.611 vs. 0.614, P=0.166). The LGA risk was consistently increased in women with abnormal fasting glucose (≥5.1mmol/l), irrespective of 1h or 2h glucose levels.
  
  
  CONCLUSIONS
  A single fasting glucose measurement performs comparably to 75-g OGTT in predicting risk of having a LGA baby.
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Songying
authors.initials: S
authors.lastname: Shen
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Lu
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Lifang
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: He
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Li
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Niannian
authors.initials: N
authors.lastname: Chen
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Xingxuan
authors.initials: X
authors.lastname: Wen
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Wanqing
authors.initials: W
authors.lastname: Xiao
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Mingyang
authors.initials: M
authors.lastname: Yuan
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Qiu
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
authors.forename: Kar Keung
authors.initials: KK
authors.lastname: Cheng
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China; Department of Neonatal Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. Electronic address: huimin.xia876001@gmail.com.
authors.forename: Huimin
authors.initials: H
authors.lastname: Xia
authors.affiliation: The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Ben Willem J
authors.initials: BWJ
authors.lastname: Mol
authors.affiliation: Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China; Department of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. Electronic address: qxiu0161@163.com.
authors.forename: Xiu
authors.initials: X
authors.lastname: Qiu
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis*; D005215:Fasting / Q000097:blood*; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D016015:Logistic Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis
chemical_list: D001786:Blood Glucose
keywords: Cesarean section; Fasting plasma glucose; Large for gestational age; Oral glucose-tolerance test; Spontaneous preterm birth