Clinical Study

Perinatal Outcome in Women Screened for Gestational Diabetes Mellitus with Normal or with One Elevated Glucose Tolerance Test Value

  • N. Cenk Sayin
  • Fu¨sun G. Varol
  • Ridvan Duran
  • Betül Acunas
  • Imran Kurt

Received Date: 23.06.2006 Accepted Date: 20.10.2006 J Turk Ger Gynecol Assoc 2007;8(1):38-43

OBJECTIVE

To investigate the perinatal outcome of women screened for gestational diabetes mellitus (GDM) who had abnormal screening and normal oral glucose tolerance test (OGTT) results or women with a single abnormal test value on OGTT.

MATERIALS-METHODS

We screened 576 pregnant women with a 50-gr oral glucose challenge test between the 24th and 26th weeks’ of gestation. Women with abnormal diabetes screening test results were followed up with standard OGTT with a 100-gr oral glucose load. According to the results 360 women were with a normal screening test (Group 1), 87 with a positive screening and all normal test values on OGTT (Group 2), 50 with a positive screening but a single abnormal test value on OGTT (gestational impaired glucose tolerance, Group 3) and 79 were diagnosed as with GDM (Group 4). Diet or diet plus insulin therapy was initiated to patients in Groups 3 and 4 as indicated. We compared perinatal outcome between these four groups. Statistical data were calculated with Post-hoc multiple comparison, Kruskal-Wallis and Chi-square tests for comparison of means, medians or for nominal variables.

RESULTS

Women with GDM had significantly higher glycosylated hemoglobin levels, large for gestational age infants, macrosomia, neonatal jaundice, neonatal intensive care unit (NICU) admission and neonatal mortality rates but lower gestational age at delivery and 1-minute Apgar scores compared to controls. Also, there were significant differences in neonatal jaundice and NICU admission rates between Groups 1 and 3, or between 2 and 3. There were significantly more macrosomic babies in Groups 3 and 4, compared to Group 2.

CONCLUSION

Women with abnormal diabetes screening tests and negative OGTT or with gestational impaired glucose tolerance seem not to be prone to develop severe adverse perinatal outcome.

Keywords: gestational diabetes mellitus, glucose tolerance test, pregnancy