Randomized Study Comparing Two Gestational Diabetes Screening Strategies in a Reference Maternity Hospital in Southern Benin

Abstract

Objective: The objective of this work is to compare two gestational diabetes screening strategies. Patients and methods: We conducted a comparative randomized study that screened gestational diabetes on pregnant women who are between 24th and 28th weeks of amenorrhea. We conducted the trials either by measuring fasting glucose values or by a glucose tolerance test performed two hours after oral loading of 75 g glucose (WHO test). The study involved 580 pregnant women (290 for each type of trial) who came for antenatal appointment at the reference maternity hospital in Porto-Novo (Benin) between February 2nd, 2015 and January 31st, 2017. Results: We detected 26 cases (9%) of gestational diabetes by the “fasting glucose value measurement method” as compared to the 18 cases (6.2%) detected by the WHO test, leading to a p-value of 0.209. The two types of test were equally relevant: Sensitivity (59.09% vs. 40.91%), specificity (50.75% vs. 49.25%), positive predictive value (8.97% vs. 6.21%), and predictive value negative (93.79% vs. 91.03%). All pregnant women tested “negative" between their 24th and their 28th weeks of amenorrhea, were tested again during the 32nd week of amenorrhea, using the WHO test method and no new case of gestational diabetes was detected. Conclusion: Fasting glucose value measurement method can be an alternative method for gestational diabetes screening in a population where the WHO test is not available.