Blood glucose limits in the diagnosis of impaired glucose tolerance during pregnancy. Relation to morbidity

Acta Obstet Gynecol Scand. 1995 Sep;74(8):589-93. doi: 10.3109/00016349509013467.

Abstract

Objective: To evaluate the accuracy of diagnosing gestational diabetes mellitus (GDM) by a 2-h blood glucose value > or = 9.0 mmol/l in the 75 g oral glucose tolerance test (OGTT). The maternal and neonatal outcome in women with a 2-h blood glucose value just below this limit, 8.0-8.9 mmol/l, is analyzed. The outcome is compared to a randomly selected control group.

Design: A comparative study.

Subjects: There were 223 women in the group with a 2-h value of 8.0 to 8.9 mmol/l in the OGTT. This group was compared to a randomly selected control group of 391 women.

Main outcome measures: Fetal outcome: perinatal mortality, birth weight, respiratory disturbances, symptomatic hypoglycemia, polycythemia, hyperbilirubinemia and traumatic deliveries. Maternal age, body mass index (BMI), pregnancy-induced hypertension (PIH) or preeclampsia and route of delivery.

Results: The women in the group with a 2-h glucose value of 8.0-8.9 mmol/l were, compared to the control group, significantly older, heavier, had a higher BMI, gave birth to heavier children and a significantly increased number of large-for-date infants, while there were no differences in neonatal mortality, morbidity or birth trauma.

Conclusions: This study shows that using the 75 g 2-h OGTT with a B-glucose limit of > or = 9.0 mmol/l instead of > or = 8.0 mmol/l to diagnose GDM during pregnancy has no major adverse effects concerning maternal and neonatal outcome in the borderline interval of 8.0 to 8.9 mmol/l.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Birth Weight
  • Female
  • Fetal Macrosomia / epidemiology
  • Fetal Macrosomia / etiology
  • Glucose Tolerance Test
  • Humans
  • Hyperbilirubinemia / epidemiology
  • Hyperbilirubinemia / etiology
  • Infant Mortality
  • Infant, Newborn
  • Infant, Newborn, Diseases / epidemiology
  • Infant, Newborn, Diseases / etiology
  • Maternal Age
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy in Diabetics / blood*
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Respiratory Distress Syndrome, Newborn / etiology
  • Sweden