van Leeuwen, M.Louwerse, M.Opmeer, B.Limpens, J.Serlie, M.Reitsma, J.Mol, B.2014-10-032014-10-032012BJOG: an International Journal of Obstetrics and Gynaecology, 2012; 119(4):393-4011470-03281471-0528http://hdl.handle.net/2440/85841Background:  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.en© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOGChallenge test; gestational diabetes mellitus; screening; systematic reviewJournal article002013678410.1111/j.1471-0528.2011.03254.x0003004487000032-s2.0-8485723429815372Mol, B. [0000-0001-6887-0262] [0000-0001-8337-550X]