Abstract:

Objective To investigate the value of fasting plasma glucose screening at gestational 6-24 weeks for gestational diabetes mellitus (GDM), and explore the influence of （FPG） on pregnancy outcomes. Methods The clinical data of 2 200 pregnant women undergoing antenatal examination and delivery were retrospectively analyzed. These women were divided into GDM group and normal group.The pregnancy outcomes and FPG levels at different gestational stages were compared between groups,the area under receiver operating characteristic (ROC) curve was used to determine the value of FPG in diagnosis of GDM, and multivariate Logistic regression analysis was employed to explore the risk factors of GDM. Results The neonatal birth weight and rates of cesarean section, macrosomia, diet and exercise therapy and insulin therapy in GDM group were significantly higher than those in normal group (P<0.05).There were also significant differences in total perinatal complications between two groups (P<0.05). The FPG levels in women at less than 24 gestational weeks and at no less than 24 gestational weeks in GDM group were significantly higher than that in normal group (P<0.001).There was no significant difference between FPG level of women at less than 24 gestational weeks and that at no less than 24 gestational weeks in GDM group （P>0.05）, while there were significant differences between FPG level of women at less than 24 gestational weeks and that at no less than 24 gestational weeks in normal group （P<0.05）. The area under ROC curve for FPG to predict GDM was 0.706 (95%CI 0.673-0.739), the optimal cutoff value was 4.6 mmol/L, and the sensitivity and specificity were 68.4% and 60.0% respectively. The positive rate of OGTT increased with FPG. Multivariate Logistic regression analysis revealed that FPG was positively related to GDM (OR 5.886, P=0.000, 95%CI 4.193-8.262). Conclusion The unfavorable pregnancy outcomes are closely related to plasma glucose level, and FPG screening for GDM has a higher predictive value. FPG screening in early pregnancy may help to treat GDM in the early stage, and decrease maternal and neonatal complications.

Key words: gestational diabetes mellitus, fasting plasma glucose, pregnancy outcome, screening