OBJECTIVE: The objective of this study was to examine the relationship between positive glucose challenge test (GCT) values and perinatal outcomes stratified by maternal body mass index (BMI). STUDY DESIGN: Retrospective cohort of singleton gestations with a GCT performed at >20 weeks and documented BMI at entry to care. Subjects were classified by GCT level and BMI. Primary outcomes included large for gestational age (LGA), macrosomia, shoulder dystocia, and pregnancy-induced hypertension. Cochran-Armitage tests for trend and logistic regression were used to compare the GCT categories. RESULTS: A total of 14,525 women met enrollment criteria-8,521 with a GCT < 120 mg/dL and 6,004 with a GCT ≥ 120 mg/dL. When BMI < 25 kg/m(2) was considered, the risks were not increased at any level of GCT for any outcome. However, for subjects with BMI ≥ 25 kg/m(2), the risk of LGA for a GCT 130 to 134 mg/dL was increased, but not at GCT of 135 to 139 mg/dL (p < 0.001). Similar, but nonsignificant, trends were observed for macrosomia and shoulder dystocia. CONCLUSION: Increasing GCT is associated with adverse outcomes primarily in women with a BMI ≥ 25 kg/m(2). Women with a BMI ≥ 25 kg/m(2) and a GCT 135 to 140 mg/dL appear to have less risk of LGA than women with GCT 130 to 134 mg/dL, suggesting a possible effect of diagnosing and treating gestational diabetes mellitus in this group. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: The objective of this study was to examine the relationship between positive glucose challenge test (GCT) values and perinatal outcomes stratified by maternal body mass index (BMI). STUDY DESIGN: Retrospective cohort of singleton gestations with a GCT performed at >20 weeks and documented BMI at entry to care. Subjects were classified by GCT level and BMI. Primary outcomes included large for gestational age (LGA), macrosomia, shoulder dystocia, and pregnancy-induced hypertension. Cochran-Armitage tests for trend and logistic regression were used to compare the GCT categories. RESULTS: A total of 14,525 women met enrollment criteria-8,521 with a GCT < 120 mg/dL and 6,004 with a GCT ≥ 120 mg/dL. When BMI < 25 kg/m(2) was considered, the risks were not increased at any level of GCT for any outcome. However, for subjects with BMI ≥ 25 kg/m(2), the risk of LGA for a GCT 130 to 134 mg/dL was increased, but not at GCT of 135 to 139 mg/dL (p < 0.001). Similar, but nonsignificant, trends were observed for macrosomia and shoulder dystocia. CONCLUSION: Increasing GCT is associated with adverse outcomes primarily in women with a BMI ≥ 25 kg/m(2). Women with a BMI ≥ 25 kg/m(2) and a GCT 135 to 140 mg/dL appear to have less risk of LGA than women with GCT 130 to 134 mg/dL, suggesting a possible effect of diagnosing and treating gestational diabetes mellitus in this group. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Romina Fakhraei; Kathryn Denize; Alexandre Simon; Ayni Sharif; Julia Zhu-Pawlowsky; Alysha L J Dingwall-Harvey; Brian Hutton; Misty Pratt; Becky Skidmore; Nadera Ahmadzai; Nicola Heslehurst; Louise Hayes; Angela C Flynn; Maria P Velez; Graeme Smith; Andrea Lanes; Natalie Rybak; Mark Walker; Laura Gaudet Journal: Int J Environ Res Public Health Date: 2022-02-12 Impact factor: 3.390