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Women With Impaired Glucose Tolerance During Pregnancy Have Significantly Poor Pregnancy Outcomes

¹ Department of Rural Health, University of Melbourne, Melbourne, Australia
² Tianjin Centre of Disease Control and Prevention, Tianjin, China
³ Tianjin Institute for Women’s Health, Tianjin, China

OBJECTIVE—This article tests the hypothesis that women with impaired glucose tolerance (IGT) have the same pregnancy outcomes as those of their counterparts with normal glucose tolerance.

RESEARCH DESIGN AND METHODS—From December 1998 to December 1999, 84 of 90 antenatal care base units (ACBUs) under the Tianjin Antenatal Care Network in China participated in the first screening program for gestational diabetes mellitus (GDM). A total of 9,471 pregnant women under the care of participating ACBUs were screened. Of the women screened, 154 were positive for IGT. Of the 154 women, 102 opted for conventional obstetric care. The comparison group was 302 women of normal glucose tolerance (NGT). The initial screening consisted of a 50-g 1-h glucose test, and was carried out at 26–30 gestational weeks. Women with a serum glucose 7.8 mmol/l were followed up with a 75-g 2-h oral glucose tolerance test. The World Health Organization’s diagnostic criteria for GDM were used.

RESULTS—Women with IGT were at increased risk for premature rupture of membranes (P-ROM) (odds ratio [OR] 10.07; 95% CI 2.90–34.93); preterm birth (6.42; 1.46–28.34); breech presentation (3.47; 1.11–10.84); and high birth weight (90th percentile or 4,000 g) (2.42; 1.07–5.46); adjusting for maternal age, pregravid BMI, hospital levels, and other confounding factors.

CONCLUSIONS—The presence of IGT in pregnancy is predictive of poor pregnancy outcomes.

Abbreviations: ACBU, antenatal care base unit • DBP, diastolic blood pressure • EPH, edema proteinuria hypertension • GDM, gestational diabetes mellitus • GOD, glucose oxidase • IGT, impaired glucose tolerance • LGA, larger than gestational age • NGT, normal glucose tolerance • OGTT, oral glucose tolerance test • P-ROM, premature rupture of membranes • RCV, routine coefficient of variance • SBP, systolic blood pressure • TSDP, Tianjin Study of Diabetes in Pregnancy • WHO, World Health Organization

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