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Acta Obstet Gynecol Scand. 2017 May;96(5):563-569. doi: 10.1111/aogs.13083. Epub 2017 Feb 9.

Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

Author information

1
Centre for Fetal Programming, Department of Epidemiology Research, State Serum Institute, Copenhagen, Denmark.
2
Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
3
Department of Endocrinology, Rigshospitalet University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
4
Department of Obstetrics, Rigshospitalet Universtiy Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
5
Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet Universtiy Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
6
Department of Public Health, Section for Epidemiology, University of Aarhus, Aarhus, Denmark.
7
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.

Abstract

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. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort.

MATERIAL AND METHODS:

We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus 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 gestational diabetes mellitus, 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 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%).

CONCLUSIONS:

The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies.

KEYWORDS:

Danish National Patient Register; gestational diabetes mellitus; hospital records review; standardized telephone interview; validation

PMID:
28027410
DOI:
10.1111/aogs.13083
[Indexed for MEDLINE]

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