Comparison of maternal-fetal outcomes in gestational diabetes and lesser degrees of glucose intolerance.
OBJECTIVE
To determine the relationships between maternal and fetal outcomes and gestational diabetes mellitus (GDM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), respectively.


METHODS
A retrospective cohort study design was used with 149 patients with abnormal oral glucose tolerance test (OGTT) and 149 normal patients. Statistical analysis used was the chi-squared test, Fisher's exact test or the Student's t-test, as appropriate. P < 0.05 was considered significant.


RESULTS
The level of hyperglycemia according to the OGTT (World Health Organization criteria) was associated with pre-eclampsia, polyhydramnios and macrosomia in GDM patients. There was no increase in the complications of preterm labor and premature rupture of membranes, despite the increased risk of polyhydramnios. Although treated with insulin, macrosomia still occurred in patients with GDM, but there was no shoulder dystocia as there was an increase in the incidence of cesarean section (CS). The IGT group was not associated with adverse fetal or maternal outcomes, but there was an increase in intervention and the incidence of CS. The IFG group was associated with a significantly increased risk of pre-eclampsia and macrosomia. These findings challenge the concept of IFG being a lesser pathology than GDM. Further prospective studies with a larger number of patients are needed to ascertain the significance of these findings.


CONCLUSIONS
There was an increased risk of pre-eclampsia and macrosomia in both the GDM and IFG patients, but IGT was not associated with adverse fetal or maternal outcomes.
Nordin
Noraihan Mohd
NM
Department of Human Growth and Development, Obstetric and Gynecology Division, University Putra Malaysia, Kuala Lumpur, Malaysia. raihan@putra.upm.edu.my
Wei
Justen Wong Han
JW
Naing
Nyi Nyi
NN
Symonds
Edwin Malcolm
EM
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology; D018149:Glucose Intolerance / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006831:Polyhydramnios / Q000209:etiology; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D001786:Blood Glucose