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Screening or diagnostic: markedly elevated glucose loading test and perinatal outcomes.

Yvonne W Cheng¹, Tania F Esakoff, Ingrid Block-Kurbisch

¹Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94143, USA. yvecheng@hotmail.com

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

|November 28, 2006

Summary

Markedly elevated glucose loading test (GLT) results, even without a gestational diabetes mellitus (GDM) diagnosis, are linked to adverse perinatal outcomes. This highlights the importance of monitoring high GLT values for improved maternal and infant health.

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A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19

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Published on: July 5, 2022

Area of Science:

Obstetrics and Gynecology
Perinatal Medicine
Endocrinology

Background:

Gestational diabetes mellitus (GDM) affects a significant number of pregnancies.
Accurate diagnosis and risk stratification are crucial for optimal perinatal outcomes.
The diagnostic utility of markedly elevated 50-g oral glucose loading test (GLT) results requires further clarification.

Purpose of the Study:

To evaluate the diagnostic value of significantly high 50-g oral glucose loading test (GLT) results (≥200 mg/dL).
To assess the association between elevated GLT results and adverse perinatal outcomes.
To compare outcomes in women with and without GDM diagnosis based on GLT levels.

Main Methods:

Retrospective cohort study of 14,771 pregnancies screened for GDM.
Analysis of the positive predictive value of 50-g GLT results.
Comparison of perinatal outcomes for GLT ≥200 mg/dL versus GLT <200 mg/dL, stratified by GDM diagnosis.
Statistical analysis using Chi-square, Student's t-test, and multivariable logistic regression.

Main Results:

Positive predictive values for GDM diagnosis ranged from 62% to 100% for GLT results between 180-189 mg/dL and ≥230 mg/dL, respectively.
Women with GLT ≥200 mg/dL but no GDM diagnosis had significantly higher adjusted odds ratios for cesarean delivery (4.18), preterm delivery (<32 weeks) (8.05), shoulder dystocia (15.14), and low Apgar scores (6.41).
Women with GDM and GLT ≥200 mg/dL also showed an elevated adjusted odds ratio for cesarean delivery (2.24) compared to those with GLT <200 mg/dL.

Conclusions:

A GLT value of ≥200 mg/dL is not definitively diagnostic for GDM but indicates a higher risk of adverse perinatal outcomes.
Elevated GLT results, irrespective of GDM diagnosis, are associated with unfavorable pregnancy and neonatal outcomes.
These findings underscore the clinical significance of monitoring high GLT values in pregnancy management.