How Reliable is the Screening Method for Gestational Diabetes Mellitus in Predicting Fetal Macrosomia?

Abstract

Background

Fetal macrosomia is a major complication of Gestational Diabetes Mellitus (GDM). Universal screening of all pregnant women has been advocated by WHO, however this remains a major challenge in low-income settings. The aim of this study is to audit the impact of universal screening method used for GDM on macrosomic delivery.

Methods

The study was a prospective study with a duration of nine months. All the pregnant women were screened for GDM. They had 75g Oral Glucose Tolerance test (OGTT) and glycated hemoglobin (HBA1C) done at 24 to 28 weeks gestation and they were followed up till delivery. Their newborns had their weight measured at birth.

Results

Ninety pregnant women were screened for GDM. The overall prevalence of GDM was 23.3%. One-hour plasma glucose correlated and independently predicted fetal macrosomia compared to fasting plasma, two-hour post-glucose load and HBA1c.

Also, one hour post glucose load had the highest specificity (97.3%) and highest OR of 11 for predicting macrosomia delivery. However, two-hour post glucose load showed the highest diagnosis for GDM (16.67%).

Conclusion

Our findings support one-hour post glucose load as the most reliable predictor of macrosomic birth but for screening of GDM, two-hour post glucose load appears more reliable