Abstract
Objective Due to poor adherence for glucose testing at 6- to 12-week postpartum among women
with gestational diabetes, we sought to determine whether a 2-hour glucose tolerance
test (GTT) during postpartum hospitalization is predictive of 6- to 12-week postpartum
glucose testing.
Study Design An institutional review board–approved prospective cohort study was performed over
3 years. Patients underwent an inpatient fasting 75-g, 2-hour GTT on either postpartum
days 2 through 4 and instructed to follow up in 6- to 12-weeks for postpartum glucose
testing. Sensitivity, specificity, positive predictive value (PPV), and negative predictive
values (NPV) of the immediate GTT to predict abnormal 6- to 12-week postpartum glucose
testing were determined.
Results Eighty women enrolled in the study completed the immediate GTT; of these, only 35
(44%) underwent 6- to 12-week postpartum glucose testing. The sensitivity, specificity,
PPV, and NPV of the immediate GTT were 100, 42.8, 30.4, and 100%, respectively.
Conclusion More than 50% of our study patients did not undergo recommended postpartum glucose
testing, coinciding with similar poor follow-up reported in the literature. With a
high NPV and high sensitivity, a negative immediate GTT may obviate the need for the
6- to 12-week GTT, while a positive GTT may identify women who should follow up closely.
Keywords
gestational diabetes - glucose tolerance test - glucose intolerance - postpartum testing
