Does raising the glucose challenge test threshold impact birthweight in Asian gravidas?
OBJECTIVE
Some authors suggest a glucose challenge test (GCT) threshold of 150 mg/dL in Asian gravidas. The impact of such a policy on outcomes is unknown.


METHODS
A retrospective cohort of 1705 Asian gravidas. Subjects (n=95) had a GCT of 140-150 mg/dL and underwent a 3-h glucose tolerance test (GTT). Matched controls (n=190) had a GCT of <140 mg/dL. Birthweight was the primary outcome and the secondary outcomes were cesarean delivery (CD) rate and macrosomia.


RESULTS
Eight subjects (11.9%) had gestational diabetes mellitus (GDM); none had GTT fasting values of >90 mg/dL. Mean birthweight was 3282 g in the subjects and 3238 g in the controls (P=0.39). There were no significant differences in the secondary outcomes.


CONCLUSIONS
Compared with controls, study patients did not deliver significantly larger infants. However, raising the GCT threshold would have missed 8 subjects (11.9%) with GDM. Raising the GCT threshold to 150 mg/dL in Asian gravidas may unacceptably lower the sensitivity of the screening test.
Koklanaris
Nikki
N
Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA. nikki.koklanaris@carolinashealthcare.org
Bonnano
Clarissa
C
Seubert
David
D
Anzai
Yuzuru
Y
Jennings
Richard
R
Lee
Men-Jean
MJ
D000328:Adult; D044466:Asian People; D001724:Birth Weight / Q000502:physiology*; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies