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

J Matern Fetal Neonatal Med. 2007 Dec;20(12):903-8. doi: 10.1080/14767050701739384.


Objective: To examine whether women with an 1-hour 50-g glucose challenge test (GCT) for gestational diabetes mellitus (GDM) between 120 and 140 mg/dL and >or=140 mg/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 >or=140 mg/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 <120 mg/dL, women with a GCT of 130-139 mg/dL and >or=140 mg/dL were more likely to have preeclampsia and operative vaginal or cesarean deliveries. Neonates born to women with a GCT of 130-139 mg/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 >or=140 mg/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 130-139 mg/dL appear to be at increased risk for perinatal morbidity. Thus, utilizing a diagnostic test in women with a GCT above 130 mg/dL should be considered.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Apgar Score
  • Cohort Studies
  • Diabetes, Gestational / diagnosis*
  • Female
  • Glucose Tolerance Test / methods*
  • Humans
  • Infant, Newborn
  • Obstetric Labor Complications*
  • Odds Ratio
  • Pregnancy
  • Pregnancy Outcome
  • Reference Values
  • Retrospective Studies