Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort

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DOI

  • Sjurdur F Olsen, Centre for Fetal Programming, Department of Epidemiology Research, State Serum Institute, Copenhagen, Denmark.
  • ,
  • Azedeh Houshmand-Oeregaard, Department of Endocrinology, Rigshospitalet University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen.
  • ,
  • Charlotta Granström, Centre for Fetal Programming, Department of Epidemiology Research, State Serum Institute, Copenhagen, Denmark.
  • ,
  • Jens Langhoff-Roos, Department of Obstetrics, Rigshospitalet Universtiy Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen.
  • ,
  • Peter Damm, Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet Universtiy Hospital, Faculty of Health and Medical Sciences, University of Copenhagen,, Copenhagen.
  • ,
  • Bodil H Bech
  • Allan A Vaag, Department of Endocrinology, Rigshospitalet University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen.
  • ,
  • Cuilin Zhang, Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.

INTRODUCTION: The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus (GDM). Our aim was to identify and validate the GDM cases in the cohort.

MATERIAL AND METHODS: We extracted clinical information from hospital records for 1609 pregnancies included in the DNBC with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a DNBC interview during pregnancy. We further validated the diagnosis of GDM in 2,126 randomly selected pregnancies from the entire DNBC. From the individual hospital records, an expert panel evaluated GDM status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians.

RESULTS: The audit categorized 783 pregnancies as GDM, corresponding to 0.89% of the 87,792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80% to 99.9%) of all cases in the entire DNBC population. Positive predictive value, however, was only 59% (56% to 61%).

CONCLUSIONS: The combined use of data from register and interview provided a high sensitivity of the GDM diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of GDM in future studies. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalActa Obstetrica et Gynecologica
Volume96
Issue5
Pages (from-to)563–569
ISSN0001-6349
DOIs
Publication statusPublished - May 2017

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