title: Pregnancy Outcomes in Women with 1-Hour Glucose Challenge Test ≥ 200 mg/dL.
abstract: OBJECTIVE
  Many protocols diagnose gestational diabetes mellitus (GDM) solely on a 1-hour glucose challenge test (GCT) ≥ 200 mg/dL. However, pregnancy outcomes in these women compared with women diagnosed with a 3-hour glucose tolerance test (GTT) has not been adequately evaluated. We hypothesize that a 1-hour GCT ≥ 200 mg/dL is associated with worse pregnancy outcomes as compared with a GCT 135 to 199 mg/dL with positive GTT.
  
  
  METHODS
  A retrospective cohort of singleton pregnancies complicated by GDM. Maternal outcomes included A2DM, preeclampsia, primary cesarean, and failed trial of labor after cesarean. Perinatal outcomes were large/small for gestational age, shoulder dystocia, and birth injury. Groups were compared with t-test and chi-square test, and logistic regression to adjust for confounders.
  
  
  RESULTS
  A total of 602 women diagnosed with GDM by 1-hour GCT 135 to 199 mg/dL and confirmatory 3-hour GTT (< 200 group) and 225 women diagnosed with 1-hour GCT ≥ 200 alone (≥ 200) were included. The ≥ 200 group had a higher incidence of preeclampsia (16.4 vs. 10.6%) and shoulder dystocia (3.1 vs. 1.0%). Adjusted odds ratio and 95% confidence interval were 1.80 (1.10-2.94) and 5.10 (1.25-20.76), respectively.
  
  
  CONCLUSIONS
  Preeclampsia and shoulder dystocia are more frequent in women with GCT ≥ 200 mg/dL than those with a positive GTT following a GCT of 135 to 199 mg/dL.
authors.affiliation: Center of Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Nana-Ama
authors.initials: NA
authors.lastname: Ankumah
authors.affiliation: Center of Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Alan T N
authors.initials: AT
authors.lastname: Tita
authors.affiliation: Center of Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Biggio
authors.affiliation: Center of Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Lorie M
authors.initials: LM
authors.lastname: Harper
mesh_terms: D000328:Adult; D001720:Birth Injuries / Q000453:epidemiology*; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D004420:Dystocia / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D007236:Infant, Small for Gestational Age; D007328:Insulin / Q000627:therapeutic use; D016015:Logistic Models; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin