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The 50-g glucose challenge test and pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes

Tan PC, Ling LP, Omar SZ

Int J Gynaecol Obstet, 2009 Apr;105(1):50-5.
PMID: 19154997 DOI: 10.1016/j.ijgo.2008.11.038

OBJECTIVE:
To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM).

METHODS:
GCT was positive if the 1-hour plasma glucose level was >or=7.2 mmol/L. GDM was diagnosed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive, and 168 had GDM. Pregnancy outcomes were extracted from hospital records. Multivariable logistic regression analysis was performed with GCT negative women as the reference group.

RESULTS:
GCT false-positive status was associated with preterm birth (adjusted odds ratio [AOR] 2.1; 95% CI, 1.2-3.7) and postpartum hemorrhage (AOR 1.7; 95% CI, 1.0-2.7). GDM was associated with labor induction (AOR 5.0; 95% CI, 3.3-7.5), cesarean delivery (AOR 2.2; 95% CI, 1.6-3.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.2-3.7), and neonatal macrosomia (AOR 2.5; 95% CI, 1.0-6.0).

CONCLUSION:
GCT false-positive women had an increased likelihood of an adverse pregnancy outcome. The role and threshold of the GCT needs re-evaluation.
Screening for gestational diabetes at antenatal booking in a Malaysian university hospital: the role of risk factors and threshold value for the 50-g glucose challenge test

Tan PC, Ling LP, Omar SZ

Aust N Z J Obstet Gynaecol, 2007 Jun;47(3):191-7.
PMID: 17550485 DOI: 10.1111/j.1479-828X.2007.00717.x

Background: The best method of screening for gestational diabetes (GDM) remains unsettled. The 50-g glucose challenge test (GCT) is used in a two-stage screening process but its best threshold value can vary according to population.

Aims: To evaluate the role of risk factors in conjunction with GCT and to determine an appropriate threshold for the one-hour venous plasma glucose with the GCT.

Method: In a prospective study, 1600 women at antenatal booking without a history of diabetes mellitus or GDM filled a form on risk factors before GCT. Women who had GCT >or= 7.2 mmol/L underwent the 75-g oral glucose tolerance test (OGTT). GDM was diagnosed according to WHO (1999) criteria.

Result: Thirty-five per cent had GCT >or= 7.2 mmol/L, 32.6% underwent OGTT and 34.5% of OGTT confirmed GDM. The GDM rate in our population was at least 11.4%. Examination of the receiver operator characteristic curve suggested that the best threshold value for the GCT in our population was >or= 7.6 mmol/L. Multivariable logistic regression demonstrated that only GCT >or= 7.6 mmol/L was an independent predictor for GDM (adjusted odds ratio 3.7: P < 0.001). After GCT, maternal age and anthropometry, OGTT during the third trimester, family history, obstetric history and glycosuria were not independent predictors of GDM.

Conclusions: Risk factors were not independent predictors of GDM in women with GCT >or= 7.2 mmol/L. GCT threshold value >or= 7.6 mmol is appropriate for the Malaysian population at high risk of GDM.
Maternal hemoglobin level and red cell indices as predictors of gestational diabetes in a multi-ethnic Asian population

Tan PC, Chai JN, Ling LP, Omar SZ

Clin Exp Obstet Gynecol, 2011;38(2):150-4.
PMID: 21793277

OBJECTIVE: To evaluate maternal hemoglobin levels and red cell indices as predictive factors for gestational diabetes (GDM).
METHOD: Data from 1,538 women were analyzed. At the first visit for prenatal care, the 50-gram glucose challenge test was followed by the 75-gram glucose tolerance test in those who screened positive. GDM was diagnosed based on the WHO (1999) criteria. Maternal complete blood count was obtained at the first visit, hospitalization for birth, and after birth. Receiver operator characteristic curves were generated to establish thresholds. Multivariable logistic regression analyses were performed to establish independent predictors of GDM.
RESULTS: GDM was diagnosed in 182/1,538 (11.8%). GDM was associated with hemoglobin level, hematocrit and erythrocyte count at the first visit for prenatal care only. Hemoglobin threshold at the first visit was established at 11.5 g/dl. After adjustment, high hemoglobin [AOR 1.5 (95% CI 1.0-2.1); p = 0.027] remained predictive of GDM.
CONCLUSIONS: High maternal hemoglobin level at the first prenatal visit is independently predictive of GDM.
Development of single-locus DNA microsatellite markers using 5'anchored ISSR-PCR method for the mangrove horseshoe crab, Carcinoscorpius rotundicauda (Latreille, 1802) in Peninsular Malaysia

Adibah AB, Ling LP, Tan SG, Faridah QZ, Christianus A

Mol Biol Rep, 2012 Apr;39(4):3815-20.
PMID: 21744263 DOI: 10.1007/s11033-011-1159-6

Horseshoe crabs are said to be declining worldwide. However, there is still no published report on the status of horseshoe crabs in Malaysia. Thus, we report here eight informative microsatellite markers that were developed using the 5'-anchored ISSR-PCR enrichment procedure to diagnose the population genetic structure of the mangrove horseshoe crab, Carcinoscorpius rotundicauda from Peninsular Malaysia. This set of markers was tested on 127 samples and showed polymorphism in this species. Hence they should be useful in future essential population genetic studies of these living fossils in the Southeast Asian region.
A study of ecological sanitation as an integrated urban water supply system: case study of sustainable strategy for Kuching City, Sarawak, Malaysia

Seng DM, Putuhena FJ, Said S, Ling LP

J Water Health, 2009 Mar;7(1):169-84.
PMID: 18957785 DOI: 10.2166/wh.2009.103

A city consumes a large amount of water. Urban planning and development are becoming more compelling due to the fact of growing competition for water, which has lead to an increasing and conflicting demand. As such, investments in water supply, sanitation and water resources management is a strong potential for a solid return. A pilot project of greywater ecological treatment has been established in Kuching city since 2003. Such a treatment facility opens up an opportunity of wastewater reclamation for reuse as secondary sources of water for non-consumptive purposes. This paper aims to explore the potential of the intended purposes in the newly developed ecological treatment project. By utilizing the Wallingford Software model, InfoWorks WS (Water Supply) is employed to carry out a hydraulic modeling of a hypothetical greywater recycling system as an integrated part of the Kuching urban water supply, where the greywater is treated, recycled and reused in the domestic environment. The modeling efforts have shown water savings of about 40% from the investigated system reinstating that the system presents an alternative water source worth exploring in an urban environment.
Isolation by the 5' anchored PCR technique and characterization of eighteen microsatellite loci in horseshoe crab (Tachypleus gigas)

Ling LP, Adibah AB, Tan SG, Christianus A, Faridah QZ

J Genet, 2011 Dec;90(3):e101-4.
PMID: 22232191