The impact of gestational diabetes mellitus on pregnancy outcome comparing different cut-off criteria for abnormal glucose tolerance.
OBJECTIVE
to examine pregnancy outcomes in relation to different categories of glucose tolerance during pregnancy.


METHODS
prospective observational cohort study.


METHODS
patient recruitment and data collection were performed in four delivery departments in southern Sweden.


METHODS
women delivering during 2003-2005; 306 with gestational diabetes mellitus, 744 with gestational impaired glucose tolerance and 329 randomly selected controls.


METHODS
all women were offered a 75 g oral glucose tolerance test during pregnancy. On the basis of their capillary 2-hour plasma glucose concentrations, three groups were identified: gestational diabetes mellitus (>10.0 mmol/l), gestational impaired glucose tolerance (8.6-9.9 mmol/l) and controls (<8.6 mmol/l). Data for the groups were compared using a population-based database.


METHODS
maternal and fetal outcomes.


RESULTS
for the gestational diabetes mellitus group, adjusted odds ratios (95% confidence intervals) for hypertensive disorders during pregnancy and induction of labor and emergency cesarean section were 2.7 (1.3-5.8), 3.1 (1.8-5.2) and 2.5 (1.5-4.4), respectively; and for Apgar score <7 at 5 minutes, need for neonatal intensive care >1 day and large-for-gestational age infant were 9.6 (1.2-78.0), 5.2 (2.8-9.6) and 2.5 (1.3-5.1), respectively. The increases in odds ratios for the gestational impaired glucose tolerance group were less pronounced but still significant for hypertension during pregnancy, induction of labor, large-for-gestational age infant and use of neonatal intensive care >1 day, with odds ratios (95% confidence interval) 2.0 (1.0-4.1), 1.8 (1.1-3.0), 2.1 (1.1-3.9) and 2.1 (1.1-3.8), respectively.


CONCLUSIONS
these data indicate that even limited degrees of maternal hyperglycemia may affect the outcome of pregnancy.
Department of Obstetrics and Gynecology in Lund, Skåne University Hospital, Lund University, Sweden. eva.k.anderberg@skane.se
Eva
E
Anderberg
Karin
K
Källén
Kerstin
K
Berntorp
D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D036861:Delivery, Obstetric / Q000379:methods; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D018149:Glucose Intolerance / Q000175:diagnosis* / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
D001786:Blood Glucose