title: [Impact of area under the curve of oral glucose tolerance test on pregnant woman with gestational diabetes mellitus].
abstract: OBJECTIVE
  To investigate whether area under the curve (AUC) of oral glucose tolerance test (OGTT) could work as a predictor of outcomes of gestational diabetes mellitus (GDM) on condition that blood glucose is controlled.
  
  
  METHODS
  A total of 1 796 women who had a standard antenatal care in Peking University First Hospital and gave single live births from July 1, 2011 to December 31, 2 013 were included. They should be diagnosed of GDM by the diagnosis criteria of gestational diabetes published by the Ministry of Health of PRC and diabetes pre-pregnancy excluded. Data were analyzed with SPSS 17.0, grouping by AUC.
  
  
  RESULTS
  (1) Women with higher AUC had a rising trend of age and a downward trend of gestational weight gain, however, not statistically significant [specifically, in the four group of less than 15.00 mmol · L⁻¹ · h⁻¹, 15.00 to 16.79 mmol · L⁻¹ · h⁻¹, 16.80 to 17.99 mmol · L⁻¹ · h⁻¹ and 18.00 mmol · L⁻¹ · h⁻¹ or more, gestational weight gain was (15.3 ± 5.2), (14.1 ± 4.8), (13.5 ± 4.7) and (13.1 ± 4.8) kg]. The prevalence of macrosomia raised while AUC increased. Those with an AUC of lower than 15.00 (mmol · L⁻¹ · h⁻¹) had a lower risk of macrosomia (P = 0.04). But those with an AUC of 18.00 (mmol · L⁻¹ · h⁻¹) or more had a higher risk of macrosomia (P = 0.02). There was a rising trend in premature birth and preeclampsia with AUC increasing but not significant (the prevalence of premature birth was 4.38%, 5.36%, 7.71% and 7.94% while that of preeclampsia was 2.85%, 4.69%, 4.67% and 5.08% in these four groups). (2) The prevalence of macrosomia was 12.76% (54/423) when overweight pre-pregnancy, significantly higher compared with 5.87% (65/1 107) in normal group. The prevalence of preeclampsia was 5.91% (25/423) and 3.34% (37/1 107) in those two groups, which was also significantly different. The obese group had a statistically highest prevalence of preeclampsia of 9.23% (12/130). (3) AUC (P < 0.05, OR = 1.113, 95% CI: 1.008-1.218), as well as gestational weight gain (P < 0.05, OR = 1.520, 95% CI: 1.279-1.806) and pre-pregnancy BMI (P < 0.05, OR = 1.183, 95% CI: 1.125-1.243) made a difference in the prevalence of macrosomia. Meanwhile, pre-pregnancy BMI made sense in the prevalence of premature labor (P < 0.05, OR = 1.059, 95% CI: 1.003-1.119) and preeclampsia (P < 0.01, OR = 1.202, 95% CI: 1.123-1.286).
  
  
  CONCLUSIONS
  AUC, as well as pre-pregnancy BMI and gestational weight gain have a significant impact on outcomes of GDM, macrosomia especially, though blood glucose is controlled. Meanwhile, AUC might be considered as a predictor of macrosomia.
authors.affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
authors.forename: Congyue
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
authors.forename: Shiping
authors.initials: S
authors.lastname: Su
authors.affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
authors.forename: Chunhong
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China; Email: yanghuixia@bjmu.edu.cn.
authors.forename: Huixia
authors.initials: H
authors.lastname: Yang
mesh_terms: D019540:Area Under Curve; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D002681:China / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D009765:Obesity / Q000453:epidemiology; D050177:Overweight; D011225:Pre-Eclampsia / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth; D011295:Prenatal Care / Q000379:methods*; D015995:Prevalence; D015430:Weight Gain
chemical_list: D001786:Blood Glucose