Prevalence of Gestational Diabetes and Macrosomic Newborns in a Mexican Population

Abstract

Prevalence of gestational diabetes was investigated in 693 pregnant patients between the 24th and 28th wk of gestation. A glucose screening test (GST) was performed with a 50-g glucose load, followed by a blood sample 1 h later. Patients with glucose levels greater than 140 mg/dl 1 h after the GST were scheduled for a full oral glucose tolerance test (OGTT). One hundred seven patients had an abnormal GST, and 30 patients (4.3%) were diagnosed as having gestational diabetes mellitus (GDM). The percentage of GDM increased significantly when glucose levels were greater than 180 mg/dl to a maximum of 84.61% when glucose levels were greater than 200 mg/dl. Also, patient age was directly related to GDM, which increased in incidence to 20% when patients greater than 26 yr had an abnormal GST. After delivery, newborn weights were compared between those born to mothers with GDM (n = 30) and those born to mothers with an abnormal GST (n = 77). Patients with an abnormal GST and normal OGTT had 12 (15.58%) macrosomic and 2 premature newborns. However, patients with GDM had 5 (16.66%) macrosomic and no premature newborns. Patients with a normal GST had 7.33% of the macrosomic newborns. There was no perinatal mortality in newborns of GDM mothers; only 1 of the 5 macrosomic newborns presented transient hypoglycemia. Evaluation of 26 GDM patients was possible after delivery, disclosing 3 (11.53%) with non-insulin-dependent diabetes mellitus and 5 (19.23%) with impaired glucose tolerance. These results showed 4.3% undetected GDM in our population and no differences in the proportion of macrosomic newborns between those born to mothers with GDM and those born to mothers with an abnormal GST.

Lack of Relationship Between Glucose Tolerance and Complications of Pregnancy in Nondiabetic Women

“…Although no significant differences between groups were found, e.g., for proportions of cesarean sections, CPD, or fetal distress, it may be that sample sizes in this study were inadequate to detect small differences. Jovanovic and Peterson (12), Frisoli et al (13), Forsbach et al (14), and Leiken et al (15) have shown that a high percentage (12-28%) of women with abnormal 50-g 1-h glucose challenge tests but normal 3-h OGTTs have babies weighing >4000 g. Some of these study samples, however, were not randomly selected (13,15). Based on these calculations we can be 95% confident that the differences between true proportions and observed sample proportions in the groups is <0.…”

Gestational Diabetes Mellitus: Influence of Race on Disease Prevalence and Perinatal Outcome in a U.S. Population

“…Studies published since the last international workshop-conference suggest that Oriental and Hispanic populations indeed may have different preva- (5), in a program of universal screening in Mexico, found a prevalence of 3.9% with the standard O'Sullivan-Mahan criteria derived for plasma. Unfortunately, 40% of patients with a positive screen failed to report for OGTT, suggesting that the true prevalence may have been greater.…”

Der orale Glukosetoleranztest (oGTT) in der Schwangerschaft

“…Da bei Schwangeren mit einem positiven GCT und negativem oGTT ähnlich hohe Raten an makrosomen Kindern auftreten wie bei Schwangeren bei denen beide Tests positiv sind (15,6 vs. 16,7 %) [25], erhebt sich die Frage, wozu ein 2. Test erforderlich sei.…”