OBJECTIVE: The objective of this study was to evaluate the ideal cutoff for the @entity413 challenge test (GCT) in twin pregnancies undergoing screening for @entity6 ( @entity6 ). STUDY DESIGN: A historical cohort of @entity1 with twin pregnancies were identified from 1 maternal-fetal medicine practice from 2005 through 2013. All @entity1 were administered a 1-hour, 50-g GCT between 24-28 weeks' gestation. All @entity1 with a GCT of >= 130 mg/dL underwent a 3-hour, 100-g oral @entity413 tolerance test. The diagnosis of @entity6 was made if 2 of the 4 values on the oral @entity413 tolerance test were abnormal (Carpenter and Coustan). The testing characteristics of the GCT for diagnosis of @entity6 were evaluated using 3 selected cutoffs: >= 130, >= 135, and >= 140 mg/dL. We excluded all @entity1 diagnosed with @entity6 <24 weeks. RESULTS: In all, 475 @entity1 with twin pregnancies underwent a GCT between 24-28 weeks. The incidence of @entity6 was 6.5%. The positive screen rate using the 3 selected cutoffs were: >= 130 mg/dL, 34.7%; >= 135 mg/dL, 28.6%; and >= 140 mg/dL, 23.4%. A GCT cutoff of >= 135 mg/dL maintained 100% sensitivity, with a specificity of 76.4%. Using this cutoff, the positive predictive value was 22.8% and the negative predictive value was 100%. Compared to a cutoff of >= 130 mg/dL, a cutoff of >= 135 mg/dL resulted in 6.1% less @entity1 testing positive while maintaining the same 100% sensitivity. CONCLUSION: In twin pregnancies, the optimal 1-hour, 50-g GCT screening cutoff appears to be >= 135 mg/dL.

Screening approach for gestational XXXX in twin pregnancies.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity6 :: ('MESH:D003920', 'Disease') :: ['gestational diabetes mellitus', 'GDM']
@entity6 :: (MESH:D003920,Disease) :: ['diabetes']
