Glucose challenge test for detecting gestational diabetes mellitus: a systematic review

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dc.contributor.authorvan Leeuwen, M.
dc.contributor.authorLouwerse, M.
dc.contributor.authorOpmeer, B.
dc.contributor.authorLimpens, J.
dc.contributor.authorSerlie, M.
dc.contributor.authorReitsma, J.
dc.contributor.authorMol, B.
dc.date.issued2012
dc.description.abstractBackground:  The best strategy to identify women with gestational diabetes mellitus (GDM) is unclear. Objectives:  To perform a systematic review to calculate summary estimates of the sensitivity and specificity of the 50-g glucose challenge test for GDM. Search strategy:  Systematic search of MEDLINE, EMBASE and Web of Science. Selection criteria:  Articles that compared the 50-g glucose challenge test with the oral glucose tolerance test (OGTT, with a 75- or 100-g reference standard) before 32 weeks of gestation. Data collection and analysis:  Summary estimates of sensitivity and specificity, with 95% confidence intervals and summary receiver operating characteristic curves, were calculated using bivariate random-effects models. Two reviewers independently selected articles that compared the 50 g glucose challenge test to the oral glucose tolerance test (OGTT, 75 or 100 gram, reference standard) before 32 weeks of gestation. Main results:  Twenty-six studies were included (13 564 women). Studies that included women with risk factors showed a pooled sensitivity of the 50-g glucose challenge test of 0.74 (95% CI 0.62–0.87), a pooled specificity of 0.77 (95% CI 0.66–0.89) (threshold value of 7.8 mmol/l), a derived positive likelihood ratio (LR) of 3.2 (95% CI 2.0–5.2) and a negative LR of 0.34 (95% CI 0.22–0.53). In studies with consecutive recruitment, the pooled sensitivity was 0.74 (95% CI 0.62–0.87) for a specificity of 0.85 (95% CI 0.80–0.91), with a derived positive LR of 4.9 (95% CI 3.5–7.0) and negative LR of 0.31 (95% CI 0.20–0.47). Increasing the threshold for disease (OGTT result) increased the sensitivity of the challenge test, and decreased the specificity. Author’s conclusions:  The 50-g glucose challenge test is acceptable to screen for GDM, but cannot replace the OGTT. Further possibilities of combining the 50-g glucose challenge test with other screening strategies should be explored.
dc.description.statementofresponsibilityM van Leeuwen, MD Louwerse, BC Opmeer, J Limpens, MJ Serlie, JB Reitsma and BWJ Mol
dc.identifier.citationBJOG: an International Journal of Obstetrics and Gynaecology, 2012; 119(4):393-401
dc.identifier.doi10.1111/j.1471-0528.2011.03254.x
dc.identifier.issn1470-0328
dc.identifier.issn1471-0528
dc.identifier.orcidMol, B. [0000-0001-6887-0262] [0000-0001-8337-550X]
dc.identifier.urihttp://hdl.handle.net/2440/85841
dc.language.isoen
dc.publisherWiley
dc.rights© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG
dc.source.urihttps://doi.org/10.1111/j.1471-0528.2011.03254.x
dc.subjectChallenge test; gestational diabetes mellitus; screening; systematic review
dc.titleGlucose challenge test for detecting gestational diabetes mellitus: a systematic review
dc.typeJournal article
pubs.publication-statusPublished

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