Oral glucose tolerance test and pregnancy outcomes

Abstract

CONTEXT: Women with Gestational Diabetes Mellitus (GDM) were at increased risk of developing maternal, neonatal complications and postpartum diabetes mellitus. AIMS: The study compares relative value of antenatal criteria used for diagnosis of GDM in predicting pregnancy outcome and insulin need. SETTINGS AND DESIGN: The study was a longitudinal, prospective clinical trial performed in Al Ain Hospital, UAE. METHODOLOGY: Eligible population was made up of patients who participated in an early screening program for GDM and had a positive oral glucose tolerance test (OGTT). A total of 165 GDM patients gave birth consecutively at Al Ain Hospital, UAE (from July, 2002 to January, 2003) and were followed-up for 6 months during postpartum period. Sources of information used were maternal, neonatal hospital records and laboratory results for patients both antenatally and postnatally. Specifi c patient information regarding maternal and neonatal complications was collected. STATISTICAL ANALYSIS: The Pearson chi-squared test and/or the Fisher’s exact test were used for analysis as appropriate. RESULTS: The number of diagnostic antenatal OGTT values obtained during diagnosis of GDM was signifi cantly correlated with the development of maternal and neonatal complications. The number of abnormal diagnostic antenatal OGTT values using Coustan and Carpenter Criteria (CCC) signifi cantly infl uenced the development of postpartum diabetes mellitus (P = 0.044) within six months of delivery. Number of abnormal OGTT values significantly contributed to insulin need during index pregnancy (P < 0.05). CONCLUSIONS: Number of abnormal OGTT values obtained during early GDM diagnosis infl uences maternal and neonatal outcomes. Antenatal