The Feasibility Analysis of Glucose Screening during 14～18 Gestational Weeks

Objective:To explore the feasibility of glucose screening during 14～18 gestational weeks.Methods:2691 pregnancy women without the history of diabetes mellitus before pregnancy were enrolled in our study. 875 pregnant women who received first 50g glucose screening test(GCT) during 14～18 gestational weeks were selected for study group(early screening group) . Part of pregnant women received GCT at fasting and others time at random. Oral glucose tolerance test(OGTT) were performed when the result of GCT was positive. All of the cases except those who had been diagnosed as gestational diabetes mellitus(GDM) and impaired glucose tolerance(IGT) received repeated GCT during 24～28 gestational weeks. Other 1816 cases received first GCT during 24～28 gestational weeks(routine screening group) .Results:①Results of GCT were positive in 103 cases for the first screening during 14～18 gestational weeks in early screening group(11.8%) .23 cases were diagnosed as GDM and IGT. 30 cases were diagnosed as GDM and IGT during 24～28 gestational weeks when rechecked. 112 cases were diagnosed as GDM and IGT in routine screening group. There was no significant difference in the incidence of GDM and IGT between two groups(P0.05);② All the cases in early screening group were divided into three groups according to the results of GCT at first time(GCT≥7.8 mmol/L、7.5≤GCT7.8 mmol/L、GCT 7.5 mmol/L) . The positive rate of repeated GCT results in the first GCT results were 77.5%、15.9%和5.5% respectively. There was significant difference in the positive rate of repeated GCT results in three groups(P0.01) .③The positive rate of first GCT results at fasting were significantly lower than that at random(9.0% vs 14.2%) ,whereas there was no significant difference in the incidence of GDM and IGT between two groups(P0.05) .④There was no significant difference in the high risk factors of GDM between early screening group(14～18 and 24～28 gestational weeks) and routine screening group(P0.05) . Conclusions:Glucose screening during 14～18 gestational weeks can find about 50% patients with abnormal glucose metabolism whether there is high risk factor. Therefore,it is feasible to perform GCT earlier.