Comparison of single-step versus two-step test for screening and diagnosis of GDM and feto-maternal outcome

P. Sujatha; Navin Kumar; Pratima Agarwal

Volume : VIII, Issue : XI, November - 2018

Comparison of single-step versus two-step test for screening and diagnosis of GDM and feto-maternal outcome

P. Sujatha, Navin Kumar, Pratima Agarwal

Abstract :

OBJECTIVE

To evaluate the effectiveness and predictive value of single step Diabetes in Pregnancy Study Group India (DIPSI) test in comparison to two step 100gram oral glucose tolerance test (OGTT) for screening and diagnosis of Gestational Diabetes Mellitus (GDM).

METHODS

Total 245 singleton pregnant women between gestation age 24 to 28 weeks attended antenatal clinic of RGGWCH, Puducherry were included for this prospective comparative study. They were divided into low and high risk groups. All women included in the study underwent DIPSI test followed by 100gmOGTT after one week irrespective of DIPSI test result. They were followed throughout pregnancy till delivery and perinatal outcomes were noted.

RESULT– The prevalence of GDM in low and high risk group was 4.08%(CI:1.12–10.12) and 10.20%(CI:5.46–14.17) respectively.The overall prevalence was 7.76%(CI:4.73–11.85). Age >25years, BMI >25, PCOS and high and middle socioeconomic status had significant correlation with occurrence of GDM. In comparison to 100gm–OGTT, DIPSI test had sensitivity of 100%(CI:82.35–100), Specificity–92.04%(CI:87.70–95.21), PPV–51.35%(CI:34.40–68.08), NPV–100%(CI:98.24–100), PLR–12.56(CI:8.06–19.56), NLR–zero and Area under ROC curve (AUC) –0.96(CI:0.93–0.98) in our study. DIPSI test had not only picked up those entire tested positive for GDM by 100gm OGTT, but also proved sensitive enough to pick up twice as more GDM cases in ethnic Indian women, who have high prevalence of diabetes. There were favourable feto–maternal outcomes, in terms of mode of delivery, birth weight and neonatal complications.

CONCLUSION

Single step DIPSI test was found to be inexpensive, simple, feasible, patient friendly does not require fasting state and reliable method for universal screening of pregnant women in developing countries like India.