Is There a Threshold Oral Glucose Tolerance Test Value for Predicting Adverse Pregnancy Outcome?

Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective This study aims to determine whether there is a threshold 3-hour oral glucose tolerance test (OGTT) value associated with accelerated risk of adverse pregnancy outcomes. Study Design In a secondary analysis of a cohort of women with untreated mild gestational glucose intolerance, we used generalized additive models with smoothing splines to explore nonlinear associations between each of the 3-hour OGTT values (fasting, 1-hour, 2-hour, and 3-hour) and adverse pregnancy outcomes, including the study's composite outcome (perinatal mortality, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and/or birth trauma), large for gestational age birth weight, small for gestational age birth weight, shoulder dystocia, neonatal hypoglycemia, gestational hypertension (gHTN), and preeclampsia. Results Among the 1,360 eligible women, each timed OGTT value was linearly associated with increased odds of composite adverse outcome. We found evidence of a departure from linearity only for the association between fasting glucose and gHTN/preeclampsia, with a stronger association for values of 85 to 94 mg/dL (p = 0.03). We found no evidence of departure from linearity for any other OGTT values and measured outcomes (all chi-square test p-values ≥ 0.05). Conclusion In a population of untreated women with mild gestational glucose intolerance and fasting OGTT < 95 mg/dL, we found an increasing risk of gHTN with a fasting glucose between 85 and 94 mg/dL.

Original languageEnglish (US)
Pages (from-to)833-838
Number of pages6
JournalAmerican Journal of Perinatology
Volume32
Issue number9
DOIs
StatePublished - Jan 16 2015

Fingerprint

Pregnancy Outcome
Glucose Tolerance Test
Pregnancy Induced Hypertension
Fasting
Glucose Intolerance
Pre-Eclampsia
Hypoglycemia
Birth Weight
Gestational Age
Neonatal Hyperbilirubinemia
Dystocia
Glucose
Perinatal Mortality
Hyperinsulinism
Chi-Square Distribution
Cohort Studies
Outcome Assessment (Health Care)
Parturition
Wounds and Injuries
Population

Keywords

  • gestational diabetes
  • glucose
  • macrosomia
  • preeclampsia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network (2015). Is There a Threshold Oral Glucose Tolerance Test Value for Predicting Adverse Pregnancy Outcome? American Journal of Perinatology, 32(9), 833-838. https://doi.org/10.1055/s-0034-1543949

Is There a Threshold Oral Glucose Tolerance Test Value for Predicting Adverse Pregnancy Outcome? / Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.

In: American Journal of Perinatology, Vol. 32, No. 9, 16.01.2015, p. 833-838.

Research output: Contribution to journalArticle

Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network 2015, 'Is There a Threshold Oral Glucose Tolerance Test Value for Predicting Adverse Pregnancy Outcome?', American Journal of Perinatology, vol. 32, no. 9, pp. 833-838. https://doi.org/10.1055/s-0034-1543949
Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Is There a Threshold Oral Glucose Tolerance Test Value for Predicting Adverse Pregnancy Outcome? American Journal of Perinatology. 2015 Jan 16;32(9):833-838. https://doi.org/10.1055/s-0034-1543949
Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. / Is There a Threshold Oral Glucose Tolerance Test Value for Predicting Adverse Pregnancy Outcome?. In: American Journal of Perinatology. 2015 ; Vol. 32, No. 9. pp. 833-838.
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abstract = "Objective This study aims to determine whether there is a threshold 3-hour oral glucose tolerance test (OGTT) value associated with accelerated risk of adverse pregnancy outcomes. Study Design In a secondary analysis of a cohort of women with untreated mild gestational glucose intolerance, we used generalized additive models with smoothing splines to explore nonlinear associations between each of the 3-hour OGTT values (fasting, 1-hour, 2-hour, and 3-hour) and adverse pregnancy outcomes, including the study's composite outcome (perinatal mortality, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and/or birth trauma), large for gestational age birth weight, small for gestational age birth weight, shoulder dystocia, neonatal hypoglycemia, gestational hypertension (gHTN), and preeclampsia. Results Among the 1,360 eligible women, each timed OGTT value was linearly associated with increased odds of composite adverse outcome. We found evidence of a departure from linearity only for the association between fasting glucose and gHTN/preeclampsia, with a stronger association for values of 85 to 94 mg/dL (p = 0.03). We found no evidence of departure from linearity for any other OGTT values and measured outcomes (all chi-square test p-values ≥ 0.05). Conclusion In a population of untreated women with mild gestational glucose intolerance and fasting OGTT < 95 mg/dL, we found an increasing risk of gHTN with a fasting glucose between 85 and 94 mg/dL.",
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