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Diabetes-Related Risks in Pregnancy With One Abnormal Oral Glucose Tolerance Test Result.

Enav Yefet1, Tal Zilberman Kimhi2, Manal Massalha3

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Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
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PubMed
Summary

Women with one abnormal oral glucose tolerance test (OGTT) value face increased risks for adverse pregnancy outcomes. These findings suggest that even a single abnormal OGTT result warrants consideration for gestational diabetes mellitus (GDM) diagnosis.

Keywords:
complicationsgestational diabetes mellitusone abnormal OGTT valuepregnancy

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Perinatal Medicine

Background:

  • Gestational diabetes mellitus (GDM) diagnosis typically requires two elevated values on the 100g oral glucose tolerance test (OGTT) per Carpenter and Coustan (C&C) criteria.
  • The clinical significance of a single abnormal OGTT value remains less defined.

Purpose of the Study:

  • To investigate the impact of a single abnormal OGTT value on pregnancy outcomes.
  • To compare outcomes between women with one abnormal OGTT value, no GDM, and diagnosed GDM.

Main Methods:

  • A retrospective cohort study analyzed data from 16,915 women between July 2013 and September 2021.
  • Women were categorized into three groups: no GDM, one abnormal OGTT value (C&C criteria), and at least two abnormal OGTT values (diagnosed GDM).
  • The primary outcome assessed was the rate of neonates large for gestational age (LGA), with secondary outcomes including macrosomia, hypertensive disease of pregnancy, and shoulder dystocia.

Main Results:

  • A single abnormal OGTT value significantly increased the risk of LGA (aOR 1.9) and macrosomia (aOR 2.4) compared to women without GDM.
  • This group also showed increased risks for hypertensive disease of pregnancy (aOR 1.4) and shoulder dystocia (aOR 3.0).
  • Compared to women with diagnosed GDM (≥2 abnormal values), those with one abnormal value had a higher risk of LGA (aOR 1.4) and macrosomia (aOR 2.1).

Conclusions:

  • Women with only one abnormal OGTT value, by C&C criteria, experience worse pregnancy outcomes than normoglycemic women.
  • Their outcomes are also worse than women with diagnosed GDM (≥2 abnormal values).
  • These findings support considering women with a single abnormal OGTT value as having GDM for appropriate management.