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Does raising the glucose challenge test threshold impact birthweight in Asian gravidas?
Nikki Koklanaris1, Clarissa Bonnano, David Seubert
1Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA. nikki.koklanaris@carolinashealthcare.org
Objective:
Some authors suggest a glucose challenge test (GCT) threshold of 150 mg/dL in Asian gravidas. The impact of such a policy on outcomes is unknown.
Study Design:
A retrospective cohort of 1705 Asian gravidas. Subjects (n=95) had a GCT of 140-150 mg/dL and underwent a 3-h glucose tolerance test (GTT). Matched controls (n=190) had a GCT of <140 mg/dL. Birthweight was the primary outcome and the secondary outcomes were cesarean delivery (CD) rate and macrosomia.
Results:
Eight subjects (11.9%) had gestational diabetes mellitus (GDM); none had GTT fasting values of >90 mg/dL. Mean birthweight was 3282 g in the subjects and 3238 g in the controls (P=0.39). There were no significant differences in the secondary outcomes.
Conclusion:
Compared with controls, study patients did not deliver significantly larger infants. However, raising the GCT threshold would have missed 8 subjects (11.9%) with GDM. Raising the GCT threshold to 150 mg/dL in Asian gravidas may unacceptably lower the sensitivity of the screening test.
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