TY - JOUR
T1 - Glucose challenge test
T2 - Screening threshold for gestational diabetes mellitus and associated outcomes
AU - Cheng, Yvonne W.
AU - McLaughlin, G. Blake
AU - Esakoff, Tania F.
AU - Block-Kurbisch, Ingrid
AU - Caughey, Aaron B.
N1 - Funding Information:
Aaron B. Caughey is supported by the National Institute of Child Health and Human Development, Grant # HD01262 as Women’s Reproductive Health Research Scholar.
PY - 2007
Y1 - 2007
N2 - 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.
AB - 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.
KW - Gestational diabetes mellitus
KW - Glucose challenge test
KW - Screening
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U2 - 10.1080/14767050701739384
DO - 10.1080/14767050701739384
M3 - Article
C2 - 18050020
AN - SCOPUS:36749070454
SN - 1476-7058
VL - 20
SP - 903
EP - 908
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 12
ER -