Correlation between Oral Glucose Tolerance Test Abnormalities and Adverse Pregnancy Outcomes in Gestational Diabetes: A Cross-Sectional Study

Abstract

Gestational diabetes mellitus (GDM) is associated with maternal and neonatal complications. We aimed to evaluate the relationship between the abnormalities of the oral glucose tolerance test (OGTT) and adverse pregnancy outcomes. This was a retrospective study of GDM patients over a five-year period in a Malaysian tertiary center. The diagnosis of GDM was based on the National Institute for Health and Care Excellence (NICE) guideline. The data on patients’ demographics, OGTT results, GDM treatment, and pregnancy outcomes were analyzed. A total of 1105 women were included in the final analysis. The percentage of women with isolated abnormal fasting glucose, isolated two-hour abnormality, and both abnormal values were 4.8%, 87.1%, and 8.1%, respectively. Women with both OGTT abnormalities had a higher risk of preeclampsia (odds ratio (OR) 4.73; 95% confidence interval (CI) 1.45–15.41) and neonatal hypoglycemia (OR 8.78; 95% CI 1.93–39.88). Isolated postprandial abnormality was associated with an 80% lesser risk of neonatal hypoglycemia (OR 0.19; 95% CI 0.04–0.87). Both isolated fasting and multiple OGTT abnormalities were associated with insulin therapy. Multiple OGTT abnormalities were a positive predictor of adverse pregnancy outcomes, while isolated postprandial abnormality was associated with a lesser risk of neonatal complication. Further prospective study is essential to validate these findings.

Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors

“…However, others reported that although optimizing blood glucose treatment can reduce the risk of PE, it is not an independent influencing factor, but the OGTT fasting blood glucose level is independent and significantly correlated with the occurrence of PE (23). Accordingly, two other studies also support the finding that OGTT blood glucose levels are an independent risk factor for the development of PE (93,94). A Chinese retrospective cohort study reported that the blood glucose level at OGTT and after treatment of GDM did not independently predict the occurrence of PE, while the fasting blood glucose level at OGTT is an important risk factor for such (54).…”

Study protocol on risk factors for the diagnosis of gestational diabetes mellitus in different trimesters and their relation to maternal and neonatal outcomes (GDM-RIDMAN)

“…Taking into consideration about 10% of incomplete or missing data in the home-based records, the sample size needed is 292 (263/0.90) cases and 584 (526/0.90) control at the ratio of 1:2. Knowing the average number of pregnancies at each of the six participating clinics (200–300 cases and 1500–3000 controls per year) and the required 1:10 ratio of independent variables to numbers of dependent variables to run a multiple logistic regression with 14 independent variables on GDM with any maternal or neonatal complication rate of 40%, 61 the study is deemed to be feasible. Therefore, we will continue to collect the home-based records from the postpartum women until at least 876 records have been collected.…”

Risk stratification of women with gestational diabetes mellitus using mutually exclusive categories based on the International Association of Diabetes and Pregnancy Study Groups criteria for the development of postpartum dysglycaemia: a retrospective cohort study

“…Defects in fasting and postprandial glucose metabolism are precipitated by different mechanisms 38. In a recent review, it was concluded that hepatic insulin resistance is a dominant feature in isolated IFG and peripheral insulin resistance is a characteristic of those with isolated IGT 39. Several interventional studies have furnished epidemiological evidence for these.…”

“…38 In a recent review, it was concluded that hepatic insulin resistance is a dominant feature in isolated IFG and peripheral insulin resistance is a characteristic of those with isolated IGT. 39 Several interventional studies have furnished epidemiological evidence for these. For example, a fasting blood glucose abnormality was determined to be a positive predictor for insulin therapy, [40][41][42] whereas a 2-hour glucose derangement was significantly associated with diet therapy and reduced risk of insulin usage.…”