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The 50-g glucose challenge test and pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes

Int J Gynaecol Obstet. 2009 Apr;105(1):50-5. doi: 10.1016/j.ijgo.2008.11.038. Epub 2009 Jan 19.

Abstract

Objective: To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM).

Methods: GCT was positive if the 1-hour plasma glucose level was >or=7.2 mmol/L. GDM was diagnosed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive, and 168 had GDM. Pregnancy outcomes were extracted from hospital records. Multivariable logistic regression analysis was performed with GCT negative women as the reference group.

Results: GCT false-positive status was associated with preterm birth (adjusted odds ratio [AOR] 2.1; 95% CI, 1.2-3.7) and postpartum hemorrhage (AOR 1.7; 95% CI, 1.0-2.7). GDM was associated with labor induction (AOR 5.0; 95% CI, 3.3-7.5), cesarean delivery (AOR 2.2; 95% CI, 1.6-3.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.2-3.7), and neonatal macrosomia (AOR 2.5; 95% CI, 1.0-6.0).

Conclusion: GCT false-positive women had an increased likelihood of an adverse pregnancy outcome. The role and threshold of the GCT needs re-evaluation.

MeSH terms

  • Adult
  • Asian People
  • Diabetes, Gestational / diagnosis*
  • False Positive Reactions
  • Female
  • Fetal Macrosomia / epidemiology
  • Fetal Macrosomia / etiology
  • Glucose Tolerance Test / methods
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Obstetric Labor Complications / epidemiology*
  • Obstetric Labor Complications / etiology
  • Postpartum Hemorrhage / epidemiology
  • Postpartum Hemorrhage / etiology
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome*
  • Premature Birth / epidemiology
  • Premature Birth / etiology
  • Risk Factors
  • Young Adult