Blood glucose limits in the diagnosis of impaired glucose tolerance during pregnancy. Relation to morbidity.
OBJECTIVE
To evaluate the accuracy of diagnosing gestational diabetes mellitus (GDM) by a 2-h blood glucose value > or = 9.0 mmol/l in the 75 g oral glucose tolerance test (OGTT). The maternal and neonatal outcome in women with a 2-h blood glucose value just below this limit, 8.0-8.9 mmol/l, is analyzed. The outcome is compared to a randomly selected control group.


METHODS
A comparative study.


METHODS
There were 223 women in the group with a 2-h value of 8.0 to 8.9 mmol/l in the OGTT. This group was compared to a randomly selected control group of 391 women.


METHODS
Fetal outcome: perinatal mortality, birth weight, respiratory disturbances, symptomatic hypoglycemia, polycythemia, hyperbilirubinemia and traumatic deliveries. Maternal age, body mass index (BMI), pregnancy-induced hypertension (PIH) or preeclampsia and route of delivery.


RESULTS
The women in the group with a 2-h glucose value of 8.0-8.9 mmol/l were, compared to the control group, significantly older, heavier, had a higher BMI, gave birth to heavier children and a significantly increased number of large-for-date infants, while there were no differences in neonatal mortality, morbidity or birth trauma.


CONCLUSIONS
This study shows that using the 75 g 2-h OGTT with a B-glucose limit of > or = 9.0 mmol/l instead of > or = 8.0 mmol/l to diagnose GDM during pregnancy has no major adverse effects concerning maternal and neonatal outcome in the borderline interval of 8.0 to 8.9 mmol/l.
Nord
E
E
Department of Woman and Child Health, Karolinska Hospital/Karolinska Institute, Stockholm, Sweden.
Hanson
U
U
Persson
B
B
D001724:Birth Weight; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology / Q000209:etiology; D005951:Glucose Tolerance Test; D006801:Humans; D006932:Hyperbilirubinemia / Q000453:epidemiology / Q000209:etiology; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000097:blood*; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000209:etiology; D013548:Sweden