Single abnormal value on 3-hour oral glucose tolerance test during pregnancy is associated with adverse maternal and neonatal outcomes: a systematic review and metaanalysis

Roeckner, Jared T.; Sánchez-Ramos, Luis; Knupp, Rubymel J.; Kaunitz, Andrew M.

doi:10.1016/j.ajog.2016.04.040

Cited by 69 publications

(36 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent systematic review showed that women with one abnormal value (OAV) in a 100 g oral glucose tolerance test (OGTT) had a significantly increased risk of adverse pregnancy outcomes, which is comparable to women with GDM [9]. The American College of Obstetricians and Gynecologists (ACOG) mentioned that OAV, as opposed to two abnormal values, might be used for the diagnosis of GDM [6].…”

Section: Introductionmentioning

confidence: 99%

Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests

Kang

Kim

et al. 2019

Diabetes Metab J

View full text Add to dashboard Cite

BackgroundWomen with one abnormal value (OAV) in a 100 g oral glucose tolerance test (OGTT) during pregnancy are reported to have an increased risk of adverse pregnancy outcomes. However, there is limited data about whether women with OAV will progress to gestational diabetes mellitus (GDM) when the OGTT is repeated.MethodsTo identify clinical and metabolic predictors for GDM in women with OAV, we conducted a retrospective study and identified women with OAV in the OGTT done at 24 to 30 weeks gestational age (GA) and repeated the second OGTT between 32 and 34 weeks of GA.ResultsAmong 137 women with OAV in the initial OGTT, 58 (42.3%) had normal, 40 (29.2%) had OAV and 39 (28.5%) had GDM in the second OGTT. Maternal age, prepregnancy body mass index, weight gain from prepregnancy to the second OGTT, GA at the time of the OGTT, and parity were similar among normal, OAV, and GDM groups. Plasma glucose levels in screening tests were different (151.8±15.7, 155.8±14.6, 162.5±20.3 mg/dL, P<0.05), but fasting, 1-, 2-, and 3-hour glucose levels in the initial OGTT were not. Compared to women with screen negative, women with untreated OAV had a higher frequency of macrosomia.ConclusionWe demonstrated that women with OAV in the initial OGTT significantly progressed to GDM in the second OGTT. Clinical parameters predicting progression to GDM were not found. Repeating the OGTT in women with OAV in the initial test may be helpful to detect GDM progression.

show abstract

Section: Introductionmentioning

confidence: 99%

Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests

Kang

Kim

et al. 2019

Diabetes Metab J

View full text Add to dashboard Cite

show abstract

“…GDM diagnosis was established according to the departmental protocol if one of the following criteria was met: glucose value ≥200 mg/dL after a 50‐g GCT, two or more abnormal values in the 100‐g OGTT using the Carpenter and Coustan criteria, or at least one abnormal value in the 100‐g OGTT using the 1979 National Diabetes Data Group (NDDG) criteria . Since the difference between the two last criteria lies only in the OGTT interpretation, we used them simultaneously, and GDM diagnosis was established if at least one of them was met . According to the departmental protocol, HbA1c and fructosamine are tested in all women with GDM diagnosis, but these tests are not used to establish the diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…18 Since the difference between the two last criteria lies only in the OGTT interpretation, we used them simultaneously, and GDM diagnosis was established if at least one of them was met. [19][20][21][22] According to the departmental protocol, HbA1c and fructosamine are tested in all women with GDM diagnosis, but these tests are not used to establish the diagnosis.…”

Section: Gdm Diagnosismentioning

confidence: 99%

Markers for undiagnosed type 2 diabetes mellitus during pregnancy—A population‐based retrospective cohort study

Yefet

Jeda

Tzur

et al. 2019

Journal of Diabetes

View full text Add to dashboard Cite

Background To examine possible markers for undiagnosed type 2 diabetes in early‐onset gestational diabetes mellitus (GDM). Methods A population‐based retrospective cohort study of women with GDM diagnosed prior to the 24th week, who delivered between 2005 and 2018, was conducted. The results of the 50‐g glucose challenge test, 100‐g oral glucose tolerance test, and the first available glycosylated hemoglobin (HbA1c) were examined as markers for type 2 diabetes diagnosed 6 to 12 weeks post pregnancy, which is suggestive of pregestational diabetes. This was done by calculating the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for each marker. These markers and additional ones were evaluated for independency by stepwise multivariate logistic regression. Results Of 69 417 pregnancies, 3321 (5%) pregnancies were with GDM. Of them, in 261 (8%) women GDM was diagnosed prior to the 24th week, and 219 (84%) women had available data for analysis. Among them, 11 (5%) women had type 2 diabetes post pregnancy. Elevated HbA1c was the most accurate marker for undiagnosed type 2 diabetes (AUC 91% with 95% CI [81%‐100%]) and the only independent marker for undiagnosed type 2 diabetes in multivariate analysis (odds ratio [OR] 19; 95% CI [3.2‐109], C statistic = 88%). Using the ROC curve, a cutoff of 5.8% predicted type 2 diabetes with 89% sensitivity, 86% specificity, 99.4% negative predictive value, and 23% positive predictive value. Conclusions Early‐onset GDM with HbA1c ≥ 5.8% should be managed as type 2 diabetes. Definitive diagnosis should be done after delivery.

show abstract

“…The adverse effects of gestational diabetes on maternal and neonatal health are well-documented [16]. Women with even one abnormal 3 h 100 g OGTT value reportedly have an increased risk of poor neonatal outcomes [17]. Therefore, the presence of gestational diabetes is screened in the clinical practice of obstetrics, and confirmed most commonly via OGTT, when indicated [18].…”

Section: Discussionmentioning

confidence: 99%

Does reactive hypoglycemia during the 100 g oral glucose tolerance test adversely affect perinatal outcomes?

Delibaş¹,

Tanrıverdi²,

Çakmak³

2018

Ginekol Pol

View full text Add to dashboard Cite

Objectives: To determine whether pregnant women who have reactive hypoglycemia during the 100 g oral glucose tolerance test (OGTT) are at an increased risk of poor pregnancy outcomes. Material and methods:We retrospectively analyzed perinatal data from 413 women who underwent a 3 h OGTT at 24-28 weeks of gestation and gave birth in our clinics between January 2012 and December 2014.Results: According to OGTT results, the majority of the subjects were normoglycemic (n = 316, 76.5%), while 49 (11.9%) were diagnosed with gestational diabetes, and 33 (8.0%) had single high glucose values. Reactive hypoglycemia was detected in only 15 patients (3.6%). The mean age of the women in the reactive hypoglycemia group was significantly lower than that of the women in the gestational diabetes and single high glucose value groups (26.4 ± 4.4 years, 31.4 ± 5.4 years, and 31.8 ± 4.3 years, respectively; p < 0.05). The newborns of the women in the reactive hypoglycemia group had higher rates of APGAR scores < 7, increased admission to the neonatal intensive care unit (NICU), and lower birth weights compared with the other groups (p < 0.001, p < 0.001, and p = 0.009, respectively). Conclusion:Reactive hypoglycemia during the 3 h 100 g OGTT is significantly associated with low APGAR scores, low birth weights, and prenatal admission to the NICU. Therefore, pregnant women who develop hypoglycemia during the 100 g OGTT performed at 24-28 weeks of gestation should receive attentive follow-up care to decrease the possibility of adverse perinatal outcomes.

show abstract

Single abnormal value on 3-hour oral glucose tolerance test during pregnancy is associated with adverse maternal and neonatal outcomes: a systematic review and metaanalysis

Cited by 69 publications

References 69 publications

Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests

Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests

Markers for undiagnosed type 2 diabetes mellitus during pregnancy—A population‐based retrospective cohort study

Does reactive hypoglycemia during the 100 g oral glucose tolerance test adversely affect perinatal outcomes?

Contact Info

Product

Resources

About