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Acta Obstet Gynecol Scand. 2008;87(1):59-62.

Adverse pregnancy outcome in women with mild glucose intolerance: is there a clinically meaningful threshold value for glucose?

Author information

1
Department of Endocrinology, Odense University Hospital, Odense, Denmark. dortemj@dadlnet.dk

Abstract

BACKGROUND:

The diagnostic criteria of gestational diabetes mellitus (GDM) have been based on the risk of future maternal diabetes rather than the short-term risk of mother and infant. Our aim was to illustrate the relation between various adverse pregnancy outcomes and maternal glucose levels in women with mild glucose intolerance using a graphical approach.

METHODS:

Observational study of 2,885 pregnant women examined with a 2-h, 75-g oral glucose tolerance test (OGTT) based on risk indicators. Only women with 2-h capillary blood glucose <9.0 mmol/l were included, as women with 2-h values > or =9.0 mmol/l were treated for GDM. Empirical frequencies of adverse outcomes were related to 2-h values by linear and quadratic logistic models. Adjustments for well-known confounders were performed by a multiple logistic model.

RESULTS:

Linear trends were demonstrated for the outcomes: shoulder dystocia, caesarean section rate (univariate analysis only), spontaneous preterm delivery, and macrosomia (large-for-gestational age infants). None of the outcomes deviated significantly from linearity. No significant trend was found for hypertension or neonatal hypoglycaemia and jaundice.

CONCLUSIONS:

A gradually increasing risk for a number of adverse pregnancy outcomes was found with increasing glucose levels. No obvious threshold value for GDM was demonstrated for 2-h values up to 9.0 mmol/l.

PMID:
18158628
DOI:
10.1080/00016340701823975
[Indexed for MEDLINE]

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