J Diabetes Complications. 2008 Apr 15;22(3):178-180
Significant thresholds for the 75-g oral glucose
tolerance test in pregnancy.
Savona-Ventura C, Chircop M.
Diabetic Pregnancy Joint Clinic, Department of
Obstetrics?Gynecology, St. Luke's Teaching Hospital,
Gwardamangia, Malta.
The significant threshold values for the 75-g oral
glucose tolerance test (oGTT) during pregnancy have
yet to be conclusively determined. This study aimed
to identify the risk significance of various set
thresholds for the oGTT result. Women undergoing a
75-g oGTT during the third trimester of pregnancy
were classified into three groups: mild gestational
impaired glucose tolerance (GIGT; 2-h postload
glucose, 8.0-8.5 mmol/l; n=75), moderate-severe GIGT
(8.6-10.9 mmol/l; n=167), and GDM (>/=11.0 mmol/l;
n=76). Outcome indicators of these three groups of
women were compared to the parameters of the women
with a presumed normal carbohydrate metabolism
(n=12,185). The results show that with increasing
oGTT thresholds, there was an increasing risk of
maternal morbidity in the form of hypertensive
disorders complicating pregnancy, as well as
obstetric intervention such as induction of labor,
cesarean delivery, and preterm delivery. The infant
was also at increasing risk with increasing oGTT
thresholds from respiratory distress, macrosomia,
and associated shoulder dystocia. It would appear,
therefore, that abnormal glucose tolerance in
pregnancy, even as defined by the World Health
Organization criteria, has proportionate risks to
both mother and child.