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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >Screening or diagnostic: Markedly elevated glucose loading test and perinatal outcomes.
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Screening or diagnostic: Markedly elevated glucose loading test and perinatal outcomes.

机译：筛查或诊断：葡萄糖负荷测试和围产期结局明显升高。

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Objective. To determine the diagnostic value of markedly elevated 50-g glucose loading test results (>/=200 mg/dL) and associated perinatal outcomes.Method. This was a retrospective cohort study of 14 771 pregnancies screened for gestational diabetes mellitus (GDM) between 1988 and 2001. The positive predictive value of the 50-g oral glucose loading test (GLT) results as measured by plasma glucose value was examined. Perinatal outcomes were assessed for women with GLT results >/=200 mg/dL compared to GLT <200 mg/dL, stratified by the diagnosis of GDM. Statistical comparisons were made using the Chi-square test and Student's t-test and potential confounding factors were controlled for using multivariable logistic regression analyses. A p value <0.05 and 95% confidence intervals were used to indicate statistical significance.Results. The positive predictive values for a GDM diagnosis were 62% for GLT results between 180 and 189 mg/dL, 79% for those between 200 and 209 mg/dL, and 100% for GLT results >/=230 mg/dL. Compared to women with a GLT result <200 mg/dL, among women not diagnosed with GDM but with a GLT >/=200 mg/dL the adjusted odds ratio (aOR) for cesarean delivery was 4.18 (95% confidence intervals, 1.15-15.2). These women also had higher aORs for preterm delivery <32 weeks (aOR = 8.05 (1.02-63.6)), shoulder dystocia (aOR = 15.14 (1.64-140)), and their neonates were more likely to have a 5-minute Apgar score <7 (aOR = 6.41 (1.23-33.3)). For women diagnosed with GDM and with a GLT >/=200 mg/dL, the aOR for cesarean delivery was also elevated compared to those with a GLT <200 mg/dL (aOR = 2.24 (1.19-4.21)).Conclusion. A GLT value of >/=200 mg/dL is not absolutely diagnostic for gestational diabetes but is associated with unfavorable perinatal outcomes.
机译：目的。确定50 g葡萄糖负荷试验结果（> / = 200 mg / dL）和相关围产期结局显着升高的诊断价值。这是一项回顾性队列研究，对1988年至2001年间筛查的14771例妊娠糖尿病（GDM）孕妇进行了研究。检查了通过血浆葡萄糖值测得的50克口服葡萄糖负荷试验（GLT）结果的阳性预测值。对GLT结果> / = 200 mg / dL的妇女进行围产期结局评估，而GLT <200 mg / dL的妇女进行围产期结局，通过诊断GDM进行分层。使用卡方检验和学生t检验进行统计比较，并使用多变量logistic回归分析控制潜在的混杂因素。 p值<0.05和95％置信区间用于表明统计学意义。对于180至189 mg / dL的GLT结果，GDM诊断的阳性预测值为62％，对于200至209 mg / dL的GLT结果为79％，对于≥230mg / dL的GLT结果为100％。与GLT结果<200 mg / dL的女性相比，在未诊断为GDM但GLT> / = 200 mg / dL的女性中，剖宫产的校正比值比（aOR）为4.18（95％置信区间为1.15） 15.2）。这些妇女的早产<32周（aOR = 8.05（1.02-63.6）），肩难产（aOR = 15.14（1.64-140））的aOR也较高，并且她们的新生儿更有可能获得5分钟的Apgar评分<7（aOR = 6.41（1.23-33.3））。对于诊断为GDM且GLT> / = 200 mg / dL的女性，与GLT <200 mg / dL的女性相比，剖宫产的aOR也升高（aOR = 2.24（1.19-4.21））。 GLT值> / = 200 mg / dL不能绝对诊断出妊娠糖尿病，但与围产期预后不良有关。

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