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Am J Perinatol 2016; 33(05): 490-494
DOI: 10.1055/s-0035-1566307
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pregnancy Outcomes in Women with 1-Hour Glucose Challenge Test ≥ 200 mg/dL

Nana-Ama Ankumah
1   Center of Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
,
Alan T. N. Tita
1   Center of Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
,
Joseph R. Biggio
1   Center of Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
,
Lorie M. Harper
1   Center of Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
› Author Affiliations
Further Information

Publication History

02 June 2015

01 October 2015

Publication Date:
03 November 2015 (online)

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Abstract

Objective Many protocols diagnose gestational diabetes mellitus (GDM) solely on a 1-hour glucose challenge test (GCT) ≥ 200 mg/dL. However, pregnancy outcomes in these women compared with women diagnosed with a 3-hour glucose tolerance test (GTT) has not been adequately evaluated. We hypothesize that a 1-hour GCT ≥ 200 mg/dL is associated with worse pregnancy outcomes as compared with a GCT 135 to 199 mg/dL with positive GTT.

Study Design A retrospective cohort of singleton pregnancies complicated by GDM. Maternal outcomes included A2DM, preeclampsia, primary cesarean, and failed trial of labor after cesarean. Perinatal outcomes were large/small for gestational age, shoulder dystocia, and birth injury. Groups were compared with t-test and chi-square test, and logistic regression to adjust for confounders.

Results A total of 602 women diagnosed with GDM by 1-hour GCT 135 to 199 mg/dL and confirmatory 3-hour GTT (< 200 group) and 225 women diagnosed with 1-hour GCT ≥ 200 alone (≥ 200) were included. The ≥ 200 group had a higher incidence of preeclampsia (16.4 vs. 10.6%) and shoulder dystocia (3.1 vs. 1.0%). Adjusted odds ratio and 95% confidence interval were 1.80 (1.10–2.94) and 5.10 (1.25–20.76), respectively.

Conclusion Preeclampsia and shoulder dystocia are more frequent in women with GCT ≥ 200 mg/dL than those with a positive GTT following a GCT of 135 to 199 mg/dL.

Keywords

gestational diabetes - shoulder dystocia - preeclampsia - birth injury

Note

Dr. Harper is supported by K12HD001258–13, PI WW Andrews, which partially supported this study.


This article was presented as a poster at the 34th Annual Meeting of the Society of Maternal-Fetal Medicine; February 3–8, 2014; New Orleans, LA.


 

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