Effect of hyperemesis gravidarum on gestational diabetes mellitus screening

Abstract Objective To clarify the effect of starvation due to hyperemesis gravidarum on the screening of gestational diabetes mellitus (GDM). Methods A retrospective study was undertaken of pregnant women who delivered at Tsukuba University Hospital, Japan, between October 1, 2010, and September 30, 2013. GDM screening was performed in the first trimester using the random blood glucose test with a cutoff value of 5.2 mmol/L and in the second trimester using a 50-g glucose challenge test with a cutoff value of 7.8 mmol/L. If the screening was positive, a 75-g oral glucose tolerance test was performed for a definite diagnosis. Results Among 2112 eligible women, 33 (1.6%) required hospitalization for hyperemesis; the remaining 2079 women formed the control group. In the first trimester, the positive GDM screening rate was significantly higher in the hyperemesis group than in the control group (13 [39.4%] vs 115 [5.5%]; P < 0.001). Additionally, the positive predictive value was significantly lower in the hyperemesis group (23.1% vs 73.9%; P < 0.001). In the second trimester, no significant differences were observed between groups. Conclusion Hyperemesis gravidarum affects the positive GDM screening rate in the first trimester.