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Clinical outcomes of pregnancy with one elevated glucose tolerance test value
Author(s) -
Kim H.S.,
Chang K.H.,
Yang J.I.,
Yang S.C.,
Lee H.J.,
Ryu H.S.
Publication year - 2002
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(02)00129-7
Subject(s) - medicine , odds ratio , respiratory distress , confidence interval , obstetrics , gestation , fetal distress , hypoglycemia , apgar score , pregnancy , gestational age , gynecology , fetus , surgery , insulin , biology , genetics
Objective: To evaluate clinical outcomes of pregnancies with one elevated glucose tolerance test. Methods: We performed a 50 g glucose challenge test (GCT) in 5019 pregnant women at 24–28 weeks of gestation. In 1170 women with plasma glucose levels over 130 mg/dl, a 100 g oral glucose tolerance test (OGTT) was performed at 28–32 weeks of gestation. During follow‐up, 282 patients were lost and in the 888 cases that were followed‐up, 189 were excluded because of GDM. Therefore 699 study patients were divided into four groups: No Elevated group (NE, N =577) with all four normal 100 g OGTT values, and Groups 1 ( N =16), 2 ( N =35), and 3 ( N =71) with one elevated 100 g OGTT value after 1, 2 and 3 h, respectively. Results: Poor maternal outcomes (NE group, Group 1, Group 2, Group 3: 17.5%, 37.6%, 22.9%, 25.3%) with pre‐eclampsia, cesarean delivery for cephalopelvic disproportion, failure to progress, or fetal distress, was highest in Group 1 (odds ratio 2.94; 95% confidence interval 1.02–8.42). Poor perinatal outcomes (15.8%, 43.1%, 14.3%, 21.1%) with any one of the following; fetal distress, Apgar score of <7 at 5 min, hypoglycemia, respiratory distress syndrome, small for gestational age and perinatal death, was also highest in Group 1 (odds ratio 4.24; 95% confidence interval 1.02–17.52). Conclusion: Pregnancies with one elevated glucose tolerance test value after 1 h exhibited increased adverse maternal and perinatal outcomes compared with the group with all normal OGTT values or the groups with an elevated glucose tolerance test value after 2 or 3 h.