The association between an oral glucose tolerance test performed at term pregnancy and obstetric outcomes

Abstract

Aims Assessing the value of oral glucose tolerance test performed at term pregnancy in identifying obstetric complications. Methods Retrospective cohort study of women with a normal 50 g glucose challenge test who also had an oral glucose tolerance test at term (defined as at or after 37 weeks of gestation). Comparison between the pathological and normal oral glucose tolerance test groups was performed. Results The mean glucose in the glucose challenge test of women in the normal oral glucose tolerance test ( n = 256) group was lower than that in the pathological oral glucose tolerance test ( N = 16) group (105 ± 17 mg/dl (5.8 ± 0.9 mmol/l) vs 117 ± 13 mg/dl (6.5 ± 0.7 mmol/l), p = 0.007). Relevant obstetrical complications did not differ significantly between the groups. Of note, in the pathological oral glucose tolerance test group only one woman delivered a macrosomic infant. Conclusions A pathological oral glucose tolerance test performed at term was unable to identify women at risk for impaired glucose metabolism-related obstetric complications and is therefore of limited clinical value and seems to be unjustified.

The impact on pregnancy outcomes of late‐onset gestational diabetes mellitus diagnosed during the third trimester: A systematic review and meta‐analysis

“…The 12 studies that were selected for the meta‐analysis included 3103 women and 3674 pregnancies (571 pregnancies with late GDM and 3103 pregnancies without late GDM) (Figure 1). 9,10,16–25 Table S4 presents the quality and risk of bias assessment of the included studies 14 . Eleven of the 12 studies included had a high‐quality score; the remaining study had a medium quality score.…”

“…Repeated testing yielded a GDM diagnosis in 13.5% (45 out of 334 women) of women who were considered as low risk 9 and in 39.1% (34 out of 87 women) of those considered at high risk 25 . In three studies, repeated testing for GDM was performed at term (after 37 weeks of pregnancy) 17,21,22 . In five studies, women with impaired glucose intolerance or one abnormal OGTT result in their repeated testing were regarded as having GDM 17–19,23,24 .…”

“…25 In three studies, repeated testing for GDM was performed at term (after 37 weeks of pregnancy). 17,21,22 In five studies, women with impaired glucose intolerance or one abnormal OGTT result in their repeated testing were regarded as having GDM. [17][18][19]23,24 Heterogeneity of population characteristics was considerable between the studies.…”

“…[17][18][19]23,24 Heterogeneity of population characteristics was considerable between the studies. This was evident by the inclusion in several studies, of women with polyhydramnios, 10,19,21,22,24 suspected LGA/macrosomia, 10,17,[20][21][22]24 glycosuria, 10 and risk factors for GDM such as obesity and family history of diabetes. 16,24,25 The characteristics of the studies included are shown in Table 1.…”

“…The 12 studies that were selected for the meta-analysis included 3103 women and 3674 pregnancies (571 pregnancies with late GDM and 3103 pregnancies without late GDM) (Figure 1). 9,10,[16][17][18][19][20][21][22][23][24][25] Table S4 presents the quality and risk of bias assessment of the included studies. 14 Eleven of the F I G U R E 2 Forest plots and summary of odds ratios of associations between late gestational diabetes and perinatal outcomes.…”