Glucose challenge test: Screening threshold for gestational diabetes mellitus and associated outcomes

Yvonne W. Cheng, G. Blake McLaughlin, Tania F. Esakoff, Ingrid Block-Kurbisch, Aaron B. Caughey

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Objective. To examine whether women with an 1-hour 50-g glucose challenge test (GCT) for gestational diabetes mellitus (GDM) between 120 and 140mg/dL and ≥140mg/dL are at risk of perinatal complications. Study design. A retrospective cohort study of women with singleton pregnancies screened for GDM between 1988 and 2001 with a 1-hour 50-g GCT. Values of GCT were stratified into four subgroups: <120, 120-129, 130-139, and ≥140mg/dL. Perinatal outcomes were compared using the Chi-square test and multivariable logistic regression analysis. Results. There were 13 901 women meeting the study criteria. Compared to women with a GCT of <120mg/dL, women with a GCT of 130-139mg/dL and ≥140mg/dL were more likely to have preeclampsia and operative vaginal or cesarean deliveries. Neonates born to women with a GCT of 130-139mg/dL also had higher odds of having a 5-minute Apgar score <7 (odds ratio (OR)=1.51, 95% confidence interval (CI) 1.01-2.29), shoulder dystocia (OR=2.02, 95% CI 1.16-2.55), birth trauma (OR=1.47, 95% CI 1.06-2.02), and composite morbidity (OR=1.25, 95% CI 1.03-1.51). Women with a GCT of ≥140mg/dL had higher odds of macrosomia (OR=1.32, 95% CI 1.13-1.54) and shoulder dystocia (OR=1.68, 95% CI 1.11-2.55). Conclusion. Women with GCT results of 130-139mg/dL appear to be at increased risk for perinatal morbidity. Thus, utilizing a diagnostic test in women with a GCT above 130mg/dL should be considered.

Original languageEnglish (US)
Pages (from-to)903-908
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume20
Issue number12
DOIs
StatePublished - Dec 10 2007
Externally publishedYes

Keywords

  • Gestational diabetes mellitus
  • Glucose challenge test
  • Screening

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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