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A Journal on Endocrine System Diseases

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Minerva Endocrinologica 2016 Sep 22


language: English

Antenatal oral glucose tolerance test in women with gestational diabetes mellitus: fasting plasma glucose is the best predictor of both large for-gestational-age newborns and postpartum glucose tolerance

Gabriela MONROY 1, 2, Diana TUNDIDOR 1, Inmaculada ORELLANA 1, Apolonia GARCÍA-PATTERSON 1, Juan M. ADELANTADO 3, Rosa CORCOY 1, 4, 5

1 Department of Endocrinology and Clinical Nutrition, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 2 Department of Endocrinology and Clinical Nutrition, Hospital Parc Sanitari de Sant Joan de Déu, Barcelona, Spain; 3 Department of Gynecology and Obstetrics, Hospital Sant i Pau, Barcelona, Spain; 4 Department of Medicine, Universitat Autònoma de Barcelona; 5 CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain


BACKGROUND: Numerous studies have evaluated the predictors of large-for-gestational- age newborns (LGA) as well as abnormal glucose tolerance (AGT) after delivery in women with gestatonal diabetes mellitus, one at a time. The present study assess the ability of glucose values on the antenatal oral glucose tolerance test (OGTT) to predict both outcomes.
METHODS: Retrospective analysis of a prospectively collected database. Gestational diabetes was diagnosed with a two-step approach. After delivery, reevaluation was performed using 2006 WHO definition of glucose tolerance. Selection criteria: 1) singleton pregnancies 2) available information on: offspring weight for age, antenatal and follow-up OGTT and additional potential predictors of LGA and AGT. 1241 women were included. Data were analyzed by multivariate logistic regression and ROC analyses. Logistic regression models were used to calculate adjusted and unadjusted odds ratios and corresponding 95% CI for 1 mmol / l increase in each glucose value (FPG, 1h, 2h, 3h) of the diagnostic 100-g OGTT, associated to the main outcomes LGA and postpartum AGT.
RESULTS: Analyzing each glucose value on antenatal OGTT, fasting plasma glucose (FPG) showed the highest OR for both outcomes: LGA (1.537, 95% CI 1.237 – 1.910) and AGT (2.288, 95% CI 1.869-2.801). On the adjusted analysis the association was attenuated, but FPG continued to be the best predictor for both outcomes.
CONCLUSIONS: In women with gestational diabetes mellitus, FPG on the diagnostic OGTT was the glycemic value that best predicted both LGA and after delivery AGT.

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