Objective: To examine whether the 50-gram glucose challenge test (GCT) is associated with perinatal outcomes in women without gestational diabetes mellitus (GDM).
Methods: This is a retrospective cohort study of 13,789 women who received the GCT and did not have a diagnosis of GDM at the University of California, San Francisco UCSF. GCT values were categorized and examined as predictors of perinatal morbidity using chi-square test and multivariable logistic regression analyses adjusting for maternal characteristics.
Results: In women with an elevated GCT but without GDM, the odds of preeclampsia, cesarean delivery, and elevated birth weight were increased. The odds of large-for-gestational age status were increased with aOR 2.0 (95% CI 1.38-2.90) in the 160-179 mg/dl group. The odds of shoulder dystocia was increased with aOR 3.35 (CI 1.03-10.88) in the ≥180 mg/dl group.
Conclusion: In women without GDM, elevated 50-gram GCT values were associated with higher odds of perinatal morbidity. These findings further support evidence that impaired glucose tolerance is a continuum with possible associated adverse outcomes even at mild ranges; additional research is required to investigate appropriate interventions for women with abnormal screens for GDM.