Women with one elevated 3-hour glucose tolerance test value: Are they at risk for adverse perinatal outcomes?

Abstract

The purpose of this study was to examine whether women with one elevated value of the 3-hour glucose tolerance test are at increased risk for adverse perinatal outcomes. This was a retrospective cohort study of singleton pregnancies that were screened for gestational diabetes mellitus with the use of the glucose loading test and with a glucose tolerance test for follow up, if screened values were positive. Perinatal outcomes in women with one elevated glucose tolerance test value were compared with the outcomes in women who screened negative by glucose loading test. The chi-square test was used to compare categorical outcomes, and multivariate logistic regression analysis was used to control for potential confounding factors; a P value of < .05 indicated statistical significance. Of 14,036 women who met the study criteria, women with one elevated glucose tolerance test value exhibited higher rates of cesarean delivery (in nulliparous women only), preeclampsia, chorioamnionitis, birth weight > 4000 g and > 4500 g, and neonatal admission to the intensive care nursery as compared with women who screened negative (P < .05 for all). Although women with one elevated glucose tolerance test value are not diagnosed with gestational diabetes mellitus, they are still at risk for adverse perinatal outcomes.