A single abnormal value of 100 g oral glucose tolerance test and pregnancy outcomes

Authors

  • Walairat Kemthong Department of Obstetrics and Gynecology, Buddhachinaraj Phitsanulok Hospital, Phitsanulok, Thailand

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20201070

Keywords:

100g oral glucose tolerance test, Gestational diabetes mellitus, Pregnancy, outcome Single abnormal value

Abstract

Background: In the worldwide, diabetes mellitus is one of the most common medical complications in pregnancy, the prevalence is about 5% and seems to increase. Objective of this study was to evaluate the effect of a single abnormal value of 100 g OGTT on pregnancy outcomes.

Methods: This retrospective cohort study was conducted from January 2014 to December 2018 to identified 600 singleton pregnancies who tested for gestational diabetes by 100g OGTT. They divided into 2 groups equally. Pregnancy outcomes of women who had a single abnormal value were compared with women who had a negative test. Pregnancies with prior cesarean delivery were excluded.

Results: Between two groups, the baseline characteristic of the patients were comparable except maternal age [33 (26.37) versus 30 (24.36), p = 0.001] was statistically higher in the study group. Even though the most of adverse pregnancy outcome tend to be higher in study group, but not reach the significance, the rate of cesarean delivery (35.7% versus 25.7, RR 1.39, 95% CI 1.08-1.78), postpartum hemorrhage (38.6% versus 30%, RR 1.29, 95% CI 1.03-1.62) and NICU admission (5.6% versus 1.0%, RR 5.69, 95% CI 1.80-17.96) were higher in study group with significant difference. Caesarean delivery (38.8% versus 28.7%, p = 0.04) and NICU admission (9.5% versus 1.9%, p = 0.0003) were more common if the blood glucose greater than 10 mg/dl normal level.

Conclusions: A single abnormal value of 100 g OGTT had significant impact on pregnancy outcome such as increase cesarean section, postpartum hemorrhage and NICU admission.

References

Cunningham GF, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Diabetes mellitus Williams Obstetrics. 25th ed. McGraw Hill; 2018:1097-1117.

Zhou T, Sun D, Li X, Heianza Y, Nisa H, Hu G, et al. Prevalence and trends in gestational diabetes mellitus among women in the United States, 2006-2016. Am Diabetes Assoc. 2018:67(Supplement 1).

Serirat S, Deerochanawong C, Sunthornthepvarakul T, Jinayon P. Gestational diabetes mellitus. J Med Assoc Thailand Chotmaihet Thangphaet. 1992;75(6):315-9.

Sumeksri P, Wongyai S, Aimpun P. Prevalence of gestational diabetes mellitus (GDM) in pregnant women aged 30 to 34 years old at Phramongkutklao Hospital. J Med Assoc Thai. 2006;89(Suppl 4):S94-S9.

Buddhachinaraj Phitsanuloke Hospital, Annual Report. 2018. Available at: www.budhos.go.th/home/wp-content/uploads/2008/06/Report59-1.pdf. Accessed 10 June 2019.

ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018;131(2):e49-e64.

Gezer A, Esen F, Mutlu H, Ozturk E, Ocak V. Prognosis of patients with positive screening but negative diagnostic test for gestational diabetes. Arch Gynecol Obstet. 2002;266(4):201-4.

McLaughlin GB, Cheng YW, Caughey AB. Women with one elevated 3-hour glucose tolerance test value: are they at risk for adverse perinatal outcomes? Am J Obstet Gynecol. 2006;194(5):e16-e9.

Thanasuan S, Borriboonhirunsarn D. Incidence of gestational diabetes mellitus among pregnant women with one abnormal value of oral glucose tolerance test. J Med Assoc Thai. 2006;89(8):1109-14.

Wang P, Lu MC, Yan YH. Abnormal glucose tolerance is associated with preterm labor and increased neonatal complications in Taiwanese women. Taiwan J Obstet Gynecol. 2013;52(4):479-84.

Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med. 2009;361(14):1339-48.

Downloads

Published

2020-03-25

Issue

Section

Original Research Articles