Antenatal oral glucose-tolerance test values and pregnancy outcomes

Abstract

AbstractObjectiveThe aim of the present study was to explore the impact of individual blood glucose values (n = 4; i.e. fasting and 1, 2 and 3 h following oral glucose administration) obtained during antenatal oral glucose-tolerance testing, together with two different sets of criteria used for diagnosis of gestational diabetes mellitus (GDM) — Carpenter and Coustan Criteria (CCC) and National Diabetes Data Group (NDDG) criteria — in predicting pregnancy outcomes and maternal insulin need.SettingAl Ain Hospital, United Arab Emirates.MethodThis observational uncontrolled cohort study gained its study subjects from a randomised, controlled, longitudinal, prospective clinical trial performed at Al Ain Hospital, Al Ain, United Arab Emirates. The eligible population was made up of all women (n = 720) who participated in an early screening programme for GDM. Those who had a positive oral glucose-tolerance test (OGTT) based on CCC were included in the study (n = 165). All recruited women with GDM were followed from time of recruitment to 6months postpartum. The sources of information used were maternal and neonatal medical records and laboratory findings for women both antenatally and postnatally.ResultsThe maternal and neonatal outcomes indicated that the number of abnormally elevated antenatal OGTT values obtained during the diagnosis of GDM was significantly correlated with development of a number of pregnancy complications. Data analysis also indicated that the number of abnormal diagnostic antenatal OGTT values using CCC was significantly correlated with development of postpartum diabetes mellitus (P = 0.044) within 6months of delivery. The number of abnormal OGTT values significantly contributed to insulin need during the index pregnancy (P < 0.05). The CCC approach was more sensitive than the NDDG methodology for predicting the onset of GDM and a number of the associated complications.ConclusionsThe study highlighted the importance of abnormal values for antenatal OGTT in identifying the need for insulin management in women with GDM.