One abnormal value or vomiting after oral glucose tolerance test in pregnancy: incidence and impact on maternal-fetal outcomes

Gynecol Endocrinol. 2023 Dec;39(1):2242951. doi: 10.1080/09513590.2023.2242951.

Abstract

Objective: To analyze pregnancy outcomes of women with one abnormal value (OAV) during oral glucose tolerance test (OGTT) or OGTT-intolerance, compared with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT) pregnant women, according to whether they received any health intervention or not.

Methods: An observational retrospective study was designed including pregnant women who gave birth at Hospital del Mar, Barcelona (Spain) during December/2014-July/2018. Baseline characteristics, pregnancy outcomes and health interventions were obtained from a database collected previously for other study. Inclusion criteria were singleton pregnancies with OAV or OGTT-intolerants who gave birth at the Hospital. GDM screening followed a two-step approach: 50 g O'Sullivan test and 100 g 3-hour OGTT if the former was abnormal.

Results: From a total of 2,662 pregnancies, 326 (12.2%) had GDM, 87 OAV (3.3%), 65 OGTT intolerance (2.4%) and 2,184 were NGT women. First trimester HbA1c in both OAV and OGTT-intolerant women was significantly higher than in NGT group, and significantly lower than in GDM pregnants. No differences in obstetric outcomes were found between OGTT-intolerants and NGT/GDM groups. Treated OGTT-intolerants had greater gestational age at delivery than non-treated ones (weeks, 39.6 ± 1.2 vs 38.0 ± 4.0, respectively). In OAV women, significant differences were observed in newborns' birthweight (g, 3227.3 ± 500.8 vs 3351.1 ± 436.7, vs GDM) and gestational age at birth (weeks, 38.7 ± 1.8 vs 39.3 ± 1.9, vs NGT), but not in macrosomia/pre-eclampsia. No differences were found according to treatment in OAV.

Conclusions: OAV and OGTT-intolerants account for a third of pregnant women referred to Diabetes Unit. Their rates of preterm birth, pre-eclampsia and macrosomia were not different from NGT or GDM women.

Keywords: OGTT-intolerance; One abnormal value; gestational diabetes mellitus; oral glucose tolerance test; outcomes; pregnancy; vomiting.

Publication types

  • Observational Study

MeSH terms

  • Blood Glucose
  • Diabetes, Gestational* / diagnosis
  • Diabetes, Gestational* / epidemiology
  • Female
  • Fetal Macrosomia
  • Glucose
  • Glucose Tolerance Test
  • Humans
  • Incidence
  • Infant, Newborn
  • Pre-Eclampsia*
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Premature Birth*
  • Retrospective Studies
  • Vomiting
  • Weight Gain

Substances

  • Glucose
  • Blood Glucose