Single fasting plasma glucose measurement compared with 75 g oral glucose-tolerance test in prediction of adverse perinatal outcomes: a prospective cohort study from China

Abstract Background The prevalence of gestational diabetes mellitus has increased markedly in recent years in China, mainly because of the introduction of new diagnostic criteria. We aimed to evaluate whether in the diagnosis of gestational diabetes mellitus, 1h and 2h glucose measurements have additional value compared with a single fasting plasma glucose measurement. Methods We included data from 6993 pregnant women who underwent a 2h 75g oral glucose-tolerance test at 22–28 weeks' gestation in the Born in Guangzhou Cohort Study in China. Outcomes included having a large for gestational age baby (≥90th percentile), caesarean section, spontaneous preterm birth, and pre-eclampsia. We calculated the area under the receiver operator characteristic curves (AUC) to assess the capacity of oral glucose-tolerance test values to predict outcomes. Findings The prevalence of large for gestational age babies was 10·8% (695 of 6448). The AUC for prediction of large for gestational age was greater for fasting plasma glucose than for 1h (0·604 vs 0·556, p=0·0002) and 2h glucose tests (0·604 vs 0·552, p