Niamh Daly1, Mary Stapleton2, Ruth O'Kelly2, Brendan Kinsley2, Sean Daly2, Michael J Turner3. 1. University College Dublin Centre for Human Reproduction, Dublin, Ireland. Electronic address: drniamhdaly@gmail.com. 2. Coombe Women and Infants University Hospital, Dublin, Ireland. 3. University College Dublin Centre for Human Reproduction, Dublin, Ireland.
Abstract
OBJECTIVE: The objective of this prospective observational study was to determine whether the preanalytical management of maternal plasma glucose samples had a significant effect on glucose measurements in obese pregnant women. STUDY DESIGN: Based on the accurate calculation of body mass index in the first trimester, obese women were recruited at their convenience. In 1 cohort, fasting glucose level was measured in early pregnancy; in the other cohort, an oral glucose tolerance test was performed at 24-28 weeks' gestation. Paired samples were taken from all women in both cohorts. The first sample was transferred to the laboratory in iced water for immediate analysis (fast-tracked analysis). The second sample was not placed on ice and transferred according to established hospital practices (hospital-tracked analysis). RESULTS: Of the 24 women who had a fasting glucose test in early pregnancy, the result was abnormal (≥5.1 mmol/L) in 7 women (29%) with hospital-tracked analysis compared with 16 women (67%) with fast-tracked analysis (P < .01). The mean phlebotomy-analysis interval was 119 minutes for the hospital-tracked samples compared with 23 minutes for the fast-tracked samples (P < .001). Of the 24 women who had a glucose tolerance test, the fasting glucose level was abnormal in 4 women (17%) after hospital-tracked analysis compared with 13 women (54%) after fast-tracked analysis (P < .01). The hospital-tracked phlebotomy-analysis interval for the fasting sample of the 24-28 week oral glucose tolerance test cohort was 166 minutes compared with 25 minutes for the fast-tracked samples (P < .001). CONCLUSION: Unless maternal fasting glucose samples are transported on ice and analyzed immediately in the laboratory, gestational diabetes mellitus will be underdiagnosed in obese women.
OBJECTIVE: The objective of this prospective observational study was to determine whether the preanalytical management of maternal plasma glucose samples had a significant effect on glucose measurements in obese pregnant women. STUDY DESIGN: Based on the accurate calculation of body mass index in the first trimester, obesewomen were recruited at their convenience. In 1 cohort, fasting glucose level was measured in early pregnancy; in the other cohort, an oral glucose tolerance test was performed at 24-28 weeks' gestation. Paired samples were taken from all women in both cohorts. The first sample was transferred to the laboratory in icedwater for immediate analysis (fast-tracked analysis). The second sample was not placed on ice and transferred according to established hospital practices (hospital-tracked analysis). RESULTS: Of the 24 women who had a fasting glucose test in early pregnancy, the result was abnormal (≥5.1 mmol/L) in 7 women (29%) with hospital-tracked analysis compared with 16 women (67%) with fast-tracked analysis (P < .01). The mean phlebotomy-analysis interval was 119 minutes for the hospital-tracked samples compared with 23 minutes for the fast-tracked samples (P < .001). Of the 24 women who had a glucose tolerance test, the fasting glucose level was abnormal in 4 women (17%) after hospital-tracked analysis compared with 13 women (54%) after fast-tracked analysis (P < .01). The hospital-tracked phlebotomy-analysis interval for the fasting sample of the 24-28 week oral glucose tolerance test cohort was 166 minutes compared with 25 minutes for the fast-tracked samples (P < .001). CONCLUSION: Unless maternal fasting glucose samples are transported on ice and analyzed immediately in the laboratory, gestational diabetes mellitus will be underdiagnosed in obesewomen.
Authors: Shali Mazaki-Tovi; Adi L Tarca; Edi Vaisbuch; Juan Pedro Kusanovic; Nandor Gabor Than; Tinnakorn Chaiworapongsa; Zhong Dong; Sonia S Hassan; Roberto Romero Journal: J Perinat Med Date: 2016-10-01 Impact factor: 1.901
Authors: Emma L Jamieson; Erica P Spry; Andrew B Kirke; David N Atkinson; Julia V Marley Journal: Int J Environ Res Public Health Date: 2019-11-14 Impact factor: 3.390
Authors: Shali Mazaki-Tovi; Edi Vaisbuch; Adi L Tarca; Juan Pedro Kusanovic; Nandor Gabor Than; Tinnakorn Chaiworapongsa; Zhong Dong; Sonia S Hassan; Roberto Romero Journal: PLoS One Date: 2015-12-04 Impact factor: 3.240