Amer J Perinatol 2017; 34(12): 1264-1270
DOI: 10.1055/s-0037-1606620
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Immediate Postpartum Glucose Tolerance Testing in Women with Gestational Diabetes: A Pilot Study

Cheryl Dinglas1, 2, Jolene Muscat1, Hye Heo1, Shahidul Islam3, Anthony Vintzileos1
  • 1Department of Obstetrics and Gynecology, NYU Winthrop Hospital, Mineola, New York
  • 2Department of Obstetrics and Gynecology, Stony Brook University Hospital, Stony Brook, New York
  • 3Department of Biostatistics, NYU Winthrop Hospital, Mineola, New York
Further Information

Publication History

20 June 2017

24 August 2017

Publication Date:
14 September 2017 (eFirst)

Abstract

Objective Due to poor adherence for glucose testing at 6- to 12-week postpartum among women with gestational diabetes, we sought to determine whether a 2-hour glucose tolerance test (GTT) during postpartum hospitalization is predictive of 6- to 12-week postpartum glucose testing.

Study Design An institutional review board–approved prospective cohort study was performed over 3 years. Patients underwent an inpatient fasting 75-g, 2-hour GTT on either postpartum days 2 through 4 and instructed to follow up in 6- to 12-weeks for postpartum glucose testing. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) of the immediate GTT to predict abnormal 6- to 12-week postpartum glucose testing were determined.

Results Eighty women enrolled in the study completed the immediate GTT; of these, only 35 (44%) underwent 6- to 12-week postpartum glucose testing. The sensitivity, specificity, PPV, and NPV of the immediate GTT were 100, 42.8, 30.4, and 100%, respectively.

Conclusion More than 50% of our study patients did not undergo recommended postpartum glucose testing, coinciding with similar poor follow-up reported in the literature. With a high NPV and high sensitivity, a negative immediate GTT may obviate the need for the 6- to 12-week GTT, while a positive GTT may identify women who should follow up closely.

Note

This article was presented as a poster at the 37th Annual Pregnancy Meeting of the Society for Maternal–Fetal Medicine from January 22 to 28, 2017 at Las Vegas, NV.