Postpartum oral glucose tolerance tests in mothers of macarosomic infants: inadequacy of current antenatal test criteria in detecting prediabetic state.
OBJECTIVE
To assess the presence of subtle carbohydrate metabolism abnormalities in otherwise healthy mothers who have given macrosomic birth by utilizing postpartum oral glucose tolerance test (PPOGTT).


METHODS
Prospective controlled study enrolled gestational diabetic women (GDM, n=10), mothers with macrosomic infants (MwMIs, n=62) and controls (n=50).


RESULTS
Receiver operating characteristic (ROC) curve analysis revealed that incremental 1-h+2-h PPOGTT value >111 mg/dl had a sensitivity of 80% and specificity of 78% in predicting antecedent diabetes. PPOGTT results were positive in 53.2% of MwMIs and 28% of controls (P<0.01). Maternal low-density lipoprotein and triglyceride levels, 50 gram glucose challenge test (50 g GCT) values and neonatal weight were the significant predictors of PPOGTT results. ROC analyses suggested that threshold of 50 g GCT should be lowered in order to better predict subjects with both macrosomia and positive PPOGTT.


CONCLUSIONS
PPOGTT may identify a subset of women with macrosomic infants who have metabolic alterations of a prediabetic state. The discrepancies between antenatal and postpartum tests may reflect the need for redefinition of currently utilized criteria in screening and diagnosis of GDM.
Bukulmez
O
O
Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey. obukulmez@hotmail.com
Durukan
T
T
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology*; D005951:Glucose Tolerance Test; D006801:Humans; D008055:Lipids / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008055:Lipids; D008077:Lipoproteins, LDL; D014280:Triglycerides