Effects on perinatal outcome of treating women with 1 elevated glucose tolerance test value

Abstract

This study was undertaken to determine whether medical nutrition therapy and home glucose monitoring can reduce complications in pregnancies with 1 elevated oral glucose tolerance test value. This was a retrospective case-control study with historical controls. Medical records of women with one elevated oral glucose tolerance test value between January 2001 and June 2006 were reviewed; routine medical nutrition therapy and self-blood glucose monitoring for this group of women was initiated in April 2004. Women before (untreated group) and after (treated group) the initiation of therapy were compared. Baseline characteristics, as well pregnancy weight gain, birthweight greater than 4000 g, incidence of shoulder dystocia, cesarean delivery rate, and neonatal metabolic complications were compared. Student t test, Mann-Whitney U test, and chi2 test were used as appropriate, with P < .05 considered significant. Fifty-seven women comprised the untreated group, and 69 were in the treated group. Except for greater prepregnancy weight in the treated group, maternal characteristics did not differ significantly between the 2 groups. Mean birthweight was similar between untreated and treated subjects (3385 g vs 3476 g, P = .45). Number of subjects with birthweights greater than 4000 g, shoulder dystocia, and unplanned cesarean deliveries were similar between the 2 groups. In our patient population, women with 1 elevated oral glucose tolerance test value did not benefit from a structured program of medical nutritional therapy and self-blood glucose monitoring.