Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study

Abstract

ObjectivesThere is no consensus regarding a possible relation between false positive glucose challenge test (GCT) results and large-for-gestational-age (LGA) infants. This study aimed to clarify the association between false positive GCT results and LGA, after adjusting for potential confounding factors, using a large clinical dataset.DesignRetrospective cohort study.SettingNational Hospital Organisation Kofu National Hospital, which is a community hospital, between January 2012 and August 2019.ParticipantsJapanese women who underwent GCT between 24 and 28 weeks of gestation at the hospital were included. After excluding those with gestational diabetes mellitus, diabetes in pregnancy and multiple pregnancies, subjects were divided into a false positive GCT group (≥140 mg/dL) and a GCT negative group (<140 mg/dL).MethodsObstetric records of patients were examined. The χ2-test and multivariable logistic regression analysis were used to investigate the association between false positive GCT results and LGA.Primary and secondary outcome measuresIncidence of LGA and the association between false positive GCT results and LGA.ResultsThe mean subject age was 31.4±5.5 years, with 43.3% nulliparity (n=974) and 2160 (96.1%) term deliveries. The incidence of LGA was 9.4% (211/2248) and 11.4% (257/2248) of the women had false positive GCT results. False positive GCT results were significantly associated with an increased risk of LGA (OR, 1.51; 95% CI, 1.02 to 2.23), after controlling for maternal age, prepregnancy maternal weight, maternal weight gain during pregnancy and parity.ConclusionsIt appears that there is a significant association between false positive GCT results and LGA. Additional research is required to confirm these results and to investigate appropriate interventions for women with abnormal screens for gestational diabetes mellitus.

Association between gestational abnormal glucose tolerance and maternal‐fetal outcomes

“…16 In contrast, Shinohara et al suggested that LGA was significantly more common in women having an abnormal GCT but normal OGTT when compared with the GCT normal group. 17 Zhoa et al found that the incidence of macrosomia was significantly greater in Chinese women having abnormal 75-g OGTT values from 1 to 3 time points. 18 Wang observed an increased risk for preterm labor and admission to the NICU when the abnormal value increased in the 100-g OGTT.…”

“…Dudhbhai et al reported no different outcomes in macrosomia, cesarean section, preeclampsia, or NICU admission when comparing pregnant women having an abnormal GCT result and a subsequent normal OGTT result with those for whom both test results were normal; therefore, they suggested that women who have an abnormal GCT and subsequent normal OGTT result were at a low‐risk of adverse outcomes 16 . In contrast, Shinohara et al suggested that LGA was significantly more common in women having an abnormal GCT but normal OGTT when compared with the GCT normal group 17 . Zhoa et al found that the incidence of macrosomia was significantly greater in Chinese women having abnormal 75‐g OGTT values from 1 to 3 time points 18 .…”

“…Relatively few studies have been designed to assess the associations between various levels of gestational abnormal glucose tolerance and maternal-fetal adverse outcomes. [15][16][17][18][19] Accordingly, for this present investigation we designed a retrospective cohort study and categorized different degrees of abnormalities of glucose tolerance to observe the risks of adverse perinatal outcomes. In particular, we focused on investigating the relationships between patients with abnormal glucose tolerance during the GCT and OGTT and their maternal-fetal outcomes.…”

“…Many previous studies have focused on investigating the relationship between GDM and maternal and neonatal outcomes. Relatively few studies have been designed to assess the associations between various levels of gestational abnormal glucose tolerance and maternal‐fetal adverse outcomes 15–19 . Accordingly, for this present investigation we designed a retrospective cohort study and categorized different degrees of abnormalities of glucose tolerance to observe the risks of adverse perinatal outcomes.…”

A new diagnostic strategy for gestational diabetes during the COVID‐19 pandemic for the Japanese population

“…While pregnant women have to spend longer periods at the hospital for GCT than those for RPG, if we can create a new strategy such that the pregnant women consume 50 g of glucose for GCT before visiting hospitals, and blood samples are collected 1 hour after consumption, it may shorten the amount of time required for them to be in a hospital. Since pregnant women with false‐positive GCT (ie, positive GCT, but negative OGTT) were at a higher risk of large for gestational age in a previous Japanese report, 5 it might be possible to manage glycemic conditions to false‐positive GCT mothers in the evolving COVID‐19 pandemic.…”