Impact of optimizing pre-analytical phase on the diagnosis of gestational diabetes and related outcomes
| Autor: | Sarah Birindelli, E. Taricco, Mauro Panteghini, Manuela Cardellicchio, Irene Cetin, Michele Vignali, Simona Borille, G. Spadaccini, Dominika Szoke |
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| Rok vydání: | 2021 |
| Předmět: |
Blood Glucose
medicine.medical_specialty endocrine system diseases Clinical Biochemistry Pre-Analytical Phase Gestational Age Pregnancy medicine Humans Overdiagnosis Preterm delivery Obstetrics business.industry Incidence (epidemiology) Biochemistry (medical) Infant Newborn Pregnancy Outcome nutritional and metabolic diseases Gestational age General Medicine Glucose Tolerance Test medicine.disease female genital diseases and pregnancy complications Gestational diabetes Diabetes Gestational Gestation Female business Blood sampling |
| Zdroj: | Clinical chemistry and laboratory medicineReferences. 59(12) |
| ISSN: | 1437-4331 |
| Popis: | Objectives Pre-analytical plasma glucose (PG) sampling methodology may significantly affect gestational diabetes mellitus (GDM) incidence, but no studies directly examined the impact on perinatal outcomes. We compared the effect on oral glucose tolerance test (OGTT) results of using for blood sampling the traditional sodium fluoride (NaF) tubes, batched at controlled temperature, and the more effective citrate-buffered tubes, in terms of GDM diagnosis and related outcomes. Methods We evaluated 578 pregnant women performing OGTT between 24- and 28-weeks’ gestation. Paired NaF and citrate blood samples were drawn and analyzed for PG. GDM diagnosis was made by applying the ‘one-step’ American Diabetes Association strategy. Data on perinatal outcomes were collected in a subset of 330 women who delivered in our hospital network. Results Using the standard NaF approach, 69 (11.9%) GDM women were detected. Using citrate PG values, 90 women were additionally identified as GDM, increasing the GDM prevalence to 27.5%. Perinatal outcomes were analyzed according to the different diagnostic allocation (NaF-diagnosed GDM, additional citrate-diagnosed GDM, and no GDM). NaF-diagnosed GDM showed a higher incidence of large for gestational age (LGA) (p=0.034), and of cesarean and preterm delivery (p Conclusions If a health care system plans to use citrate tubes for GDM diagnosis, considerations about clinical implications are mandatory by balancing higher sensitivity in detecting a poor glycemic control with effects on outcomes to avoid “overdiagnosis”. |
| Databáze: | OpenAIRE |
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