Adverse pregnancy outcome in women with mild glucose intolerance: is there a clinically meaningful threshold value for glucose?

Acta Obstet Gynecol Scand. 2008;87(1):59-62. doi: 10.1080/00016340701823975.


Background: The diagnostic criteria of gestational diabetes mellitus (GDM) have been based on the risk of future maternal diabetes rather than the short-term risk of mother and infant. Our aim was to illustrate the relation between various adverse pregnancy outcomes and maternal glucose levels in women with mild glucose intolerance using a graphical approach.

Methods: Observational study of 2,885 pregnant women examined with a 2-h, 75-g oral glucose tolerance test (OGTT) based on risk indicators. Only women with 2-h capillary blood glucose <9.0 mmol/l were included, as women with 2-h values > or =9.0 mmol/l were treated for GDM. Empirical frequencies of adverse outcomes were related to 2-h values by linear and quadratic logistic models. Adjustments for well-known confounders were performed by a multiple logistic model.

Results: Linear trends were demonstrated for the outcomes: shoulder dystocia, caesarean section rate (univariate analysis only), spontaneous preterm delivery, and macrosomia (large-for-gestational age infants). None of the outcomes deviated significantly from linearity. No significant trend was found for hypertension or neonatal hypoglycaemia and jaundice.

Conclusions: A gradually increasing risk for a number of adverse pregnancy outcomes was found with increasing glucose levels. No obvious threshold value for GDM was demonstrated for 2-h values up to 9.0 mmol/l.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Birth Weight
  • Blood Glucose / metabolism
  • Cesarean Section
  • Diabetes, Gestational / blood*
  • Dystocia / blood
  • Female
  • Glucose Intolerance / blood*
  • Glucose Tolerance Test
  • Humans
  • Hypertension / blood
  • Infant, Newborn
  • Logistic Models
  • Pregnancy
  • Pregnancy Outcome*
  • Premature Birth / blood


  • Blood Glucose