Screening Accuracy of the 50 g-Glucose Challenge Test in Twin Compared With Singleton Pregnancies

Abstract

Context: The optimal 50 g-glucose challenge test (GCT) cutoff for the diagnosis of gestational diabetes mellitus (GDM) in twin pregnancies is unknown. Objective: This work aimed to explore the screening accuracy of the 50 g-GCT and its correlation with the risk of large for gestational age (LGA) newborn in twin compared to singleton pregnancies. A population-based retrospective cohort study (2007-2017) was conducted in Ontario, Canada. Participants included patients with a singleton (n=546892 [98.4%]) or twin (n=8832 [1.6%]) birth who underwent screening for GDM using the 50 g-GCT. Methods: We compared the screening accuracy, risk of GDM, and risk of LGA between twin and singleton pregnancies using various 50 g-GCT cutoffs. Results: For any given 50 g-GCT result, the probability of GDM was higher (P=.0.007), whereas the probability of LGA was considerably lower in the twin compared with the singleton group, even when a twin-specific growth chart was used to diagnose LGA in the twin group (P