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使用 50 克葡萄糖挑战试验预测小于胎龄儿。

Use of the 50-g glucose challenge test to predict small-for-gestational-age neonates.

机构信息

Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey.

Department of Biostatistics, Hacettepe University, Ankara, Turkey.

出版信息

J Diabetes. 2020 Nov;12(11):791-797. doi: 10.1111/1753-0407.13068. Epub 2020 Jun 18.

Abstract

BACKGROUND

To determine a cutoff value for the 50-g glucose challenge test (50-g GCT) for the prediction of small-for-gestational-age (SGA) neonates.

METHODS

This retrospective cohort study was conducted among pregnant women who were screened with the 50-g GCT at Hacettepe University Hospital between 1 January 2016 and 31 March 2019. Patients with 50-g GCT values <74 mg/dL (<10th percentile) served as the study group (n = 244), while patients with 50-g GCT values between 74 to 139 mg/dL served as the control group (n = 3104). Groups were compared in terms of demographic features, clinical characteristics, and obstetric outcomes. Logistic regression analysis was used to determine independent predictors of SGA. Receiver operating characteristic curves were used to assess the performance of 50-g GCT values in predicting SGA.

RESULTS

Lower birthweight, birthweight percentile, and 5th-minute Apgar values, together with higher rates of SGA, were observed in the study group (P < .001 for all). A 50-g GCT value below the 10th percentile (odds ratio: 3.29, 95% CI: 2.31-4.69, P < .001) was a significant independent factor for SGA. A cutoff value of 89.5 mg/dL (84.9% sensitivity, 85.6% specificity) was determined for SGA.

CONCLUSIONS

Low 50-g GCT values (<89.5 mg/dL) may be an early indicator for SGA.

摘要

背景

确定 50 克葡萄糖挑战试验(50-g GCT)的截断值,以预测小于胎龄儿(SGA)新生儿。

方法

本回顾性队列研究纳入了 2016 年 1 月 1 日至 2019 年 3 月 31 日在哈塞特佩大学医院接受 50-g GCT 筛查的孕妇。50-g GCT 值<74mg/dL(<第 10 百分位数)的患者作为研究组(n=244),50-g GCT 值在 74 至 139mg/dL 之间的患者作为对照组(n=3104)。比较两组的人口统计学特征、临床特征和产科结局。采用逻辑回归分析确定 SGA 的独立预测因素。使用受试者工作特征曲线评估 50-g GCT 值预测 SGA 的性能。

结果

研究组的出生体重、出生体重百分位数和 5 分钟 Apgar 值较低,SGA 发生率较高(所有 P 值均<.001)。50-g GCT 值低于第 10 百分位数(比值比:3.29,95%置信区间:2.31-4.69,P<.001)是 SGA 的显著独立因素。确定 89.5mg/dL(84.9%的敏感性,85.6%的特异性)为 SGA 的截断值。

结论

低 50-g GCT 值(<89.5mg/dL)可能是 SGA 的早期指标。

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