The significance of one abnormal glucose tolerance test value on adverse outcome in pregnancy

Langer, Oded; Brustman, Lois; Anyaegbunam, Akolisa; Rs, Mazze

doi:10.1016/0020-7292(88)90066-5

Cited by 29 publications

(40 citation statements)

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“…The results of this study are consistent with previous reports that minor abnormalities of glucose metabolism without GDM are a significant risk factor for fetal overgrowth (3,4,(6)(7)(8)19). The level of risk is related to gestational age at the onset of abnormal maternal glucose metabolism.…”

Section: Discussionsupporting

confidence: 92%

Risk factors for fetal macrosomia: the importance of a positive oral glucose challenge test

Mello¹,

Parretti²,

Mecacci³

et al. 1997

European Journal of Endocrinology

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Objective: The aim of this study was to investigate whether minor abnormalities of glucose metabolism without gestational diabetes are a risk factor for fetal overgrowth. Design: A sample of 1883 unselected white mother-infant pairs were screened for gestational diabetes using a 50 g 1-h oral glucose challenge test (GCT) in two periods of pregnancy: early (16-20 weeks) and late (26-30 weeks). Methods: The effects of risk factors (glucose metabolism, previous history of mothers, obesity, multiparity and age of mothers) were estimated using a multinomial logit model. Results: The level of risk was related to gestational age at the appearance of an abnormal GCT. Patients with an abnormal GCT in the early and late periods of pregnancy (Group 1) had a risk of delivering a large for gestational age (LGA) infant seven times higher than the control group (normal GCT in both periods), and patients with a normal GCT in the early period and an abnormal GCT in the late period (Group 2) showed a risk three times higher than the control group. Among the historical risk factors for LGA infants, such as maternal obesity, multiparity, previous gestational diabetes and previous delivery of an infant weighing 4000 g or more, only the latter was associated with fetal overgrowth with a risk level 4.7 higher than the control group. Group 1 patients had a significantly higher incidence of pregnancy-induced hypertension and preterm birth. There were no differences in the frequency of 5-min Apgar score <7 and metabolic complications among the infants of all groups. We found a significantly higher rate of shoulder dystocia in Group 1 infants than in infants in the other groups. Conclusions: Our results suggest that a positive GCT at 26-30 weeks is the most important risk factor for fetal overgrowth. This result was strongly enforced in patients who had also shown a positive early GCT at 16-20 weeks.

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Section: Discussionsupporting

confidence: 92%

Risk factors for fetal macrosomia: the importance of a positive oral glucose challenge test

Mello¹,

Parretti²,

Mecacci³

et al. 1997

European Journal of Endocrinology

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“…1 Pregnancy loss is significantly higher among women with diabetes compared to the non-diabeticpopulation. 2 The effect of hyperglycaemia on the pregnancy outcome varies with the level of maternal blood glucose and the time during pregnancy with uncontrolled hyperglycaemia. Hyperglycaemia occurring early in pregnancy and during organogenesis as in the case of Overt DM, is associated with risk of congenital malformation, macrosomia, stillbirth, birth asphyxia and preterm delivery, while the same complications might appear with GDM but less frequently and less severe due to late occurrence of hyperglycaemia.…”

Section: Introductionmentioning

confidence: 99%

Maternal and perinatal outcomes in diabetic pregnancies at BPKIHS

Das

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Diabetes has become a global pandemic because of aging population, sedentary life style, urbanization, and increasing incidence of obesity; this study was aimed to identify the maternal and perinatal outcome in Diabetes complicating pregnancies and to compare the outcome in Gestational Diabetes Mellitus and Overt Diabetes Mellitus.Methods: This was a descriptive study conducted from 1st April 2013-31st March 2014 on total 75 pregnant women. All antenatally diagnosed cases of GDM and overt diabetes, booked or unbooked, whoever came for delivery were studied. Both mothers and neonates were followed up in ante-partum, intra-partum, and post-partum period till their stay in hospital. Management of the patient was done as per the hospital protocol.Results: Out of 75 cases enrolled, 25.33% had GDM and 16% had overt diabetes mellitus.57.33%patients were multigravida, among which 40% had GDM and 17.33% had Overt Diabetes Mellitus.61.33% patients underwent LSCS, of which 41.33% had GDM and 20% had overt diabetes mellitus. Obstetric complication was more common in GDM patients (30.66%) compared to Overt (22.66%). 89.33%babies had good neonatal outcome and 10.66% babies (6.66% of GDM mothers and 4% of overt mothers) had poor neonatal outcome (macrosomia, hypoglycaemia, prematurity, respiratory distress with NICU stay and use of antibiotics, poor APGAR (<7 at 5 min), gross congenital malformation, hyperbilirubinemia, stillbirth and neonatal death).Conclusions: Maternal and perinatal complications was commonly seen in diabetic pregnancy though more common in GDM.The time has come for the Government of Nepal to implement an effective plan to the benefit of pregnant women with diabetes during pregnancy.

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“…10 Some suggest that criteria currently in wide use for the diagnosis of GDM are too restrictive and that lesser degrees of hyperglycemia increase risk of adverse perinatal outcomes. [11][12][13][14][15][16] Conversely, others believe that systematic efforts to identify GDM should be stopped unless data become available to link significant morbidities to specific degrees of glucose intolerance. 8 Lack of international uniformity in the approach to ascertainment and diagnosis of GDM has been a major hurdle.…”

mentioning

confidence: 99%

Evaluation of the incidence and outcome of gestational diabetes mellitus using the current international consensus guidelines for diagnosing hyperglycaemia in pregnancy

Nair

Sandhu

Biswas

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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The significance of one abnormal glucose tolerance test value on adverse outcome in pregnancy

Cited by 29 publications

References 0 publications

Risk factors for fetal macrosomia: the importance of a positive oral glucose challenge test

Risk factors for fetal macrosomia: the importance of a positive oral glucose challenge test

Maternal and perinatal outcomes in diabetic pregnancies at BPKIHS

Evaluation of the incidence and outcome of gestational diabetes mellitus using the current international consensus guidelines for diagnosing hyperglycaemia in pregnancy

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