Pregnancy outcomes in women without gestational diabetes mellitus related to the maternal glucose level. Is there a continuum of risk?
OBJECTIVE
To examine selected pregnancy outcomes in women without gestational diabetes mellitus to see whether there was a continuum of risk related to the maternal glucose level.


METHODS
Consecutive women attending two prenatal clinics and three obstetricians in private practice were tested for GDM at the beginning of the third trimester using a 75-g glucose load in the fasting state. The rate of induction, the number of assisted deliveries, the presence of pregnancy-induced hypertension, fetal birth weights, and morbidity were examined with respect to the maternal 2-h glucose level.


RESULTS
Data were available for 1,441 women with a 2-h glucose level < 8.0 mmol/l (144 mg/dl). For each 1.0 mmol/l (18 mg/dl) increase in the glucose level, the odds in favor of an assisted delivery increased by 15.2%, and the odds in favor of the baby being admitted to a special care nursery (SCN) increased by 22.6%. There was no significant association between maternal glucose levels and the probability of either pregnancy-induced hypertension or a large-for-gestational-age (LGA) baby after adjustment for other variables.


CONCLUSIONS
In normal women there is a continuum of risk related to the maternal glucose level 2 h after a glucose tolerance test for the probability of having an assisted delivery and the likelihood of the baby being admitted to an SCN. The chance of having pregnancy-induced hypertension or a LGA baby also increased as the maternal glucose level increased but could be largely explained by an increasing body mass index.
Moses
R G
RG
Illawarra Area Health Service and the University of Wollongong, New South Wales, Australia.
Calvert
D
D
D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D002585:Cesarean Section; D036861:Delivery, Obstetric; D016640:Diabetes, Gestational; D005006:Ethnicity; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D009017:Morbidity; D009517:New South Wales; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000097:blood*; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011336:Probability; D012016:Reference Values; D012044:Regression Analysis; D012307:Risk Factors
D001786:Blood Glucose