A simplified oral glucose tolerance test in pregnancy: compliance and results

Anderberg, Eva; Källén, Karin; Berntorp, Kerstin; Frid, Anders; Åberg, Anders

doi:10.1080/00016340701532444

Cited by 40 publications

(49 citation statements)

References 16 publications

(14 reference statements)

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“…Though not regarded as a diagnostic standard [25], capillary finger-tip tests have been used in the screening programme for GDM in southern Sweden ever since they were first introduced in 1995 [13]. For practical reasons, this was regarded as a prerequisite when introducing the OGTT on a large scale.…”

Section: Discussionmentioning

confidence: 99%

“…The screening programme for GDM in southern Sweden has been described in detail elsewhere [13]. Briefly, a 75-g OGTT is offered to all women in the twenty-eighth week of gestation after overnight fasting and also in week 12 if there is a history of GDM in previous pregnancies or a first-degree relative with diabetes.…”

Section: Methodsmentioning

confidence: 99%

“…During the recruitment period, OGTT results from the local antenatal clinics were sent to the study coordinator, enabling identification of the test results of women who consented to be enrolled; it also ensured correct sampling technique [13]. Initially, 11 976 OGTT results in total were reported.…”

Section: Methodsmentioning

confidence: 99%

“…In southern Sweden, universal screening for GDM with a 75-g OGTT has been performed at the antenatal clinics since 1995, with no major changes in the diagnostic procedure. The diagnosis of GDM is based on the 2-h capillary glucose concentration [13]. During the years 2003–2005, pregnant women, representing different glucose categories according to the OGTT, were invited to take part in a follow-up study postpartum, the Mamma Study.…”

Section: Introductionmentioning

confidence: 99%

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Seasonal Pattern in the Diagnosis of Gestational Diabetes Mellitus in Southern Sweden

Katsarou

Claesson

Ignell

et al. 2016

Journal of Diabetes Research

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Aim. The aim of this study was to examine seasonal patterns in glucose tolerance and in the diagnosis of gestational diabetes mellitus (GDM). Methods. Altogether, 11 538 women underwent a 75-g oral glucose tolerance test (OGTT) in the twenty-eighth week of pregnancy during the years 2003–2005 in southern Sweden. GDM was defined by the 2-h capillary glucose concentration in the OGTT (≥8.9 mmol/L). Chi-squared test, analysis of variance, and regression analyses were used for statistical evaluations. Results. The seasonal frequency of GDM ranged from 3.3% in spring to 5.5% in summer (p < 0.0001). Mean 2-h glucose concentrations followed the same seasonal trend, with a difference of 0.15 mmol/L between winter and summer (p < 0.0001). The 2-h glucose level increased by 0.009 mmol/L for every degree increase in temperature (p < 0.0001). In regression analysis, summer (June–August) was associated with increased 2-h glucose level (p < 0.001) and increased frequency of GDM compared to the other seasons (odds ratio 1.51, 95% confidence interval 1.24–1.83, and p < 0.001). Conclusions. Our findings suggest seasonal variation in the 2-h glucose concentration in the OGTT and in the proportion of women diagnosed with GDM, with a peak in the summer.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Seasonal Pattern in the Diagnosis of Gestational Diabetes Mellitus in Southern Sweden

Katsarou

Claesson

Ignell

et al. 2016

Journal of Diabetes Research

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“…A minor part of non-GDM women performed an OGTT with a normal result. In the southern part of Sweden, all pregnant women have been offered a simplified OGTT (omitting fasting blood glucose) as a one-step screening and diagnostic test since 1995 (33). The main diagnostic criteria for GDM applied in Sweden are based on the Diabetes in Pregnancy Study Group recommendation from 1991, i.e., a fasting capillary whole blood glucose ≥6.1 mmol/L (fasting plasma glucose ≥7.0 mmol/L) and/or 2-h capillary whole blood glucose ≥9 mmol/L (plasma glucose ≥10 mmol/L) after 75-g OGTT.…”

Section: Methodsmentioning

confidence: 99%

Disproportionate Body Composition and Neonatal Outcome in Offspring of Mothers With and Without Gestational Diabetes Mellitus

et al. 2013

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OBJECTIVEHigh birth weight is a risk factor for neonatal complications. It is not known if the risk differs with body proportionality. The primary aim of this study was to determine the risk of adverse pregnancy outcome in relation to body proportionality in large-for-gestational-age (LGA) infants stratified by maternal gestational diabetes mellitus (GDM).RESEARCH DESIGN AND METHODSPopulation-based study of all LGA (birth weight [BW] >90th percentile) infants born to women with GDM (n = 1,547) in 1998–2007. The reference group comprised LGA infants (n = 83,493) born to mothers without diabetes. Data were obtained from the Swedish Birth Registry. Infants were categorized as proportionate (P-LGA) if ponderal index (PI) (BW in grams/length in cm3) was ≤90th percentile and as disproportionate (D-LGA) if PI >90th percentile. The primary outcome was a composite morbidity: Apgar score 0–3 at 5 min, birth trauma, respiratory disorders, hypoglycemia, or hyperbilirubinemia. Logistic regression analysis was used to obtain odds ratios (ORs) for adverse outcomes.RESULTSThe risk of composite neonatal morbidity was increased in GDM pregnancies versus control subjects but comparable between P- and D-LGA in both groups. D-LGA infants born to mothers without diabetes had significantly increased risk of birth trauma (OR 1.19 [95% CI 1.09–1.30]) and hypoglycemia (1.23 [1.11–1.37]). D-LGA infants in both groups had significantly increased odds of Cesarean section.CONCLUSIONSThe risk of composite neonatal morbidity is significantly increased in GDM offspring. In pregnancies both with and without GDM, the risk of composite neonatal morbidity is comparable between P- and D-LGA.

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Association Between History of Adverse Pregnancy Outcomes and Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography

Lawesson

Swahn

Pihlsgård

et al. 2023

JAMA

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ImportanceAdverse pregnancy outcomes are recognized risk enhancers for cardiovascular disease, but the prevalence of subclinical coronary atherosclerosis after these conditions is unknown.ObjectiveTo assess associations between history of adverse pregnancy outcomes and coronary artery disease assessed by coronary computed tomography angiography screening.Design, Setting, and ParticipantsCross-sectional study of a population-based cohort of women in Sweden (n = 10 528) with 1 or more deliveries in 1973 or later, ascertained via the Swedish National Medical Birth Register, who subsequently participated in the Swedish Cardiopulmonary Bioimage Study at age 50 to 65 (median, 57.3) years in 2013-2018. Delivery data were prospectively collected.ExposuresAdverse pregnancy outcomes, including preeclampsia, gestational hypertension, preterm delivery, small-for-gestational-age infant, and gestational diabetes. The reference category included women with no history of these exposures.Main Outcomes and MeasuresCoronary computed tomography angiography indexes, including any coronary atherosclerosis, significant stenosis, noncalcified plaque, segment involvement score of 4 or greater, and coronary artery calcium score greater than 100.ResultsA median 29.6 (IQR, 25.0-34.9) years after first registered delivery, 18.9% of women had a history of adverse pregnancy outcomes, with specific pregnancy histories ranging from 1.4% (gestational diabetes) to 9.5% (preterm delivery). The prevalence of any coronary atherosclerosis in women with a history of any adverse pregnancy outcome was 32.1% (95% CI, 30.0%-34.2%), which was significantly higher (prevalence difference, 3.8% [95% CI, 1.6%-6.1%]; prevalence ratio, 1.14 [95% CI, 1.06-1.22]) compared with reference women. History of gestational hypertension and preeclampsia were both significantly associated with higher and similar prevalence of all outcome indexes. For preeclampsia, the highest prevalence difference was observed for any coronary atherosclerosis (prevalence difference, 8.0% [95% CI, 3.7%-12.3%]; prevalence ratio, 1.28 [95% CI, 1.14-1.45]), and the highest prevalence ratio was observed for significant stenosis (prevalence difference, 3.1% [95% CI, 1.1%-5.1%]; prevalence ratio, 2.46 [95% CI, 1.65-3.67]). In adjusted models, odds ratios for preeclampsia ranged from 1.31 (95% CI, 1.07-1.61) for any coronary atherosclerosis to 2.21 (95% CI, 1.42-3.44) for significant stenosis. Similar associations were observed for history of preeclampsia or gestational hypertension among women with low predicted cardiovascular risk.Conclusions and RelevanceAmong Swedish women undergoing coronary computed tomography angiography screening, there was a statistically significant association between history of adverse pregnancy outcomes and image-identified coronary artery disease, including among women estimated to be at low cardiovascular disease risk. Further research is needed to understand the clinical importance of these associations.

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A simplified oral glucose tolerance test in pregnancy: compliance and results

Abstract: Decentralised general OGTT is a reliable and effective method to diagnose GDM. OGTT is twice as sensitive as RGM, and the severity of GDM in the cases identified with OGTT did not differ from the severity of those identified with RGM.

Cited by 40 publications

References 16 publications

Seasonal Pattern in the Diagnosis of Gestational Diabetes Mellitus in Southern Sweden

Seasonal Pattern in the Diagnosis of Gestational Diabetes Mellitus in Southern Sweden

Disproportionate Body Composition and Neonatal Outcome in Offspring of Mothers With and Without Gestational Diabetes Mellitus

Association Between History of Adverse Pregnancy Outcomes and Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography

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