Risk factors for fetal macrosomia: the importance of a positive oral glucose challenge test

1997 ◽  
pp. 27-33 ◽  
Author(s):  
G Mello ◽  
E Parretti ◽  
F Mecacci ◽  
R Lucchetti ◽  
C Lagazio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Challenge Test ◽  
Control Group ◽  
Oral Glucose ◽  
Glucose Challenge Test ◽  
Glucose Challenge ◽  
Group 1

OBJECTIVE: The aim of this study was to investigate whether minor abnormalities of glucose metabolism without gestational diabetes are a risk factor for fetal overgrowth. DESIGN: A sample of 1883 unselected white mother-infant pairs were screened for gestational diabetes using a 50 g 1-h oral glucose challenge test (GCT) in two periods of pregnancy: early (16-20 weeks) and late (26-30 weeks). METHODS: The effects of risk factors (glucose metabolism, previous history of mothers, obesity, multiparity and age of mothers) were estimated using a multinomial logit model. RESULTS: The level of risk was related to gestational age at the appearance of an abnormal GCT. Patients with an abnormal GCT in the early and late periods of pregnancy (Group 1) had a risk of delivering a large for gestational age (LGA) infant seven times higher than the control group (normal GCT in both periods), and patients with a normal GCT in the early period and an abnormal GCT in the late period (Group 2) showed a risk three times higher than the control group. Among the historical risk factors for LGA infants, such as maternal obesity, multiparity, previous gestational diabetes and previous delivery of an infant weighing 4000 g or more, only the latter was associated with fetal overgrowth with a risk level 4.7 higher than the control group. Group 1 patients had a significantly higher incidence of pregnancy-induced hypertension and preterm birth. There were no differences in the frequency of 5-min Apgar score < 7 and metabolic complications among the infants of all groups. We found a significantly higher rate of shoulder dystocia in Group 1 infants than in infants in the other groups. CONCLUSIONS: Our results suggest that a positive GCT at 26-30 weeks is the most important risk factor for fetal overgrowth. This result was strongly enforced in patients who had also shown a positive early GCT at 16-20 weeks.

scholarly journals Association of risk factors of GDM with outcome of GCT in obstetrical population

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Rubina Sohail ◽  
Tahir Bashir ◽  
Khalida Javaid ◽  
Farrukh Zaman
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Predictive Value ◽  
Challenge Test ◽  
Antenatal Clinic ◽  
Factor Group ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Objective: To determine the association of risk factors of Gestational Diabetes Mellitus (GDM) to outcome of Glucose Challenge Test (GCT). Place and Duration of Study: From February 2000 to October 2000 at the antenatal clinic of Unit-II at Services Hospital. Subject and Methods: One thousand pregnant women attending antenatal clinic at 24-28 weeks of gestation at Services Hospital were included. Glucose challenge test was performed after a history with special reference to diabetic risk factors. Results: Risk factors were identified in 198 (19.8%); while there were no risk factors in 802 (80.2%) women. An oral glucose tolerance test (OGTT) was carried out in all glucose challenge test positive patients. Out of 198 women with risk factors, 50 women were glucose challenge test positive while 148 were screen negative. Out of 802 women without risk factors 54 were GCT positive while 748 were screen negative. The positive predictive value was 48% and the negative predictive value was 83% Out of ten gestational diabetic women, six (3%) belonged to the risk factor group While four (0.5%) were in the no risk factor group. Conclusion: pregnant women with positive risk factors for diabetes mellitus were found to have a six times greater chance of developing gestational diabetes as compared to those with no risk factors.

scholarly journals Gestational Diabetes in Mid-trimester Pregnancy in South Asian Women Based on the Oral Glucose Challenge Test and Risk Factor Predictors: A Prospective Observational Study

2021 ◽  
Author(s):  
Ibtesam Nomani ◽  
Mehreen Y Rana ◽  
Grace Lindsay
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
South Asian ◽  
Challenge Test ◽  
Asian Women ◽  
Oral Glucose ◽  
South Asian Women ◽  
Glucose Challenge Test ◽  
Glucose Challenge ◽  
History Of

Introduction: Gestational Diabetes Mellitus (GDM) is a condition potentially occurring during pregnancy. It is associated with adverse foetal and maternal outcomes and is particularly prevalent in South Asian women who comprised this study sample. Aim: To provide a critical analysis of the information on GDM risk that can be identified from screening using the Oral Glucose Challenge Test (OGCT-50 g). Materials and Methods: A prospective cohort study was conducted over eight months. Purposive sampling was used to collect demographic and clinical data {age; Body mass Index (BMI); parity; history of Diabetes Mellitus (DM) in a first degree relative and histories of GDM, polyhydramnious, macrosomia, birth congenital abnormalities and still birth} from 300 South Asian women in mid-trimester pregnancy who consented to undertake an OGCT-50g. Excluded were primigravidas, women with DM or other medical conditions, and women who were unwilling or unable to give informed written consent. Descriptive, comparative and multivariate logistic analyses were used to investigate strengths of correlation between OGCT outcomes and clinical/historical risk factors. Results: The OGCT were 107 (35.7%) positive and 193 (64.3%) negative. The threshold for body mass risk was identified as 27.5 kg/m2. Women with two or more risk factors were OGCT positive on 72.9% occasions whereas women with one or no risk factor were OGCT negative on 81.9% occasions. Approximately, 50% of women had a family history of DM as their only risk factor and 24% of them were OGCT positive. Conclusion: The BMI was the strongest determinant of a positive OGCT result. The logistic regression analysis demonstrated that using the lower BMI threshold of 27.5 compared to 30.0 [as per National Institute for Health and Care Excellence (NICE) guideline] improved agreement between risk factors profile was assessed and OGCT results.

scholarly journals The application of 50g oral glucose challenge test in screening for gestational diabetes mellitus in patients attending antenatal care OPD

2017 ◽  
Vol 6 (5) ◽  
pp. 1952
Author(s):  
Disha Andhiwal Rajput ◽  
Jaya Kundan Gedam
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Gestational Hypertension ◽  
Challenge Test ◽  
Oral Glucose ◽  
Average Risk ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Background: To screen patients at average risk for Gestational Diabetes using 50g Glucose Challenge test, to ascertain the prevalence of Gestational diabetes through further diagnostic testing and to prevent and manage complications. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Women with GDM are at risk for maternal and foetal complications, so it is important to screen all the pregnant woman.Methods: This study was conducted in 198 patients between 24 and 28 weeks of gestation, attending the Antenatal clinic. 50g oral glucose is administered irrespective of time of the last meal and plasma glucose is measured one hour later. Patients with plasma glucose levels more than 140 mg/dl were subjected to a 100g oral glucose tolerance test, patients with two or more abnormal reading were labelled as GDM and managed accordingly.Results: Prevalence of GDM in our study was 9.59%. Maternal complications like gestational hypertension, vaginal infections and foetal complications were much higher in GDM patients as compare to non GDM group.Conclusions: GDM is a disease which adversely affects both mother as well as foetus. It is concluded that 50 gm glucose challenge test at 24-28 weeks of gestation with a cut-off value of 140 mg/dl is a reliable screening test for GDM. This test offers the best combination of ease and economy of use and reproducibility in screening for gestational diabetes mellitus in average risk patients.

scholarly journals One step oral glucose challenge test as screening and diagnostic test for Gestational Diabetes Mellitus

2019 ◽  
Vol 14 (2) ◽  
pp. 42-45
Author(s):  
Manisha Yadav ◽  
Gehanath Baral
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Test ◽  
Challenge Test ◽  
Single Step ◽  
Oral Glucose ◽  
Fasting State ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Aim: The Diabetes in Pregnancy Study Group of India (DIPSI, 2010) guidelines recommend the non-fasting 75-g oral glucose challenge test (OGCT) as a single-step screening and diagnostic test for gestational diabetes mellitus (GDM). The aim of this study was to assess the validity of DIPSI criteria by comparing with the World Health Organization (WHO) 1999 criteria of diagnosing GDM. Methods: This study was a hospital based prospective comparative study conducted among 282 pregnant women, of gestational age of 24-28 weeks attending antenatal OPD of Patan hospital. The OGCT was performed on them irrespective of fasting state and without any dietary preparation and they were again asked to come after 3 days of unrestricted carbohydrate diet in fasting state for WHO 2-hour oral glucose tolerance test (OGTT) with 75 gram of glucose load. The value of OGCT >140 mg/dl is diagnostic of GDM (DIPSI 2010). For the reliability of this test, it was compared with WHO 2-hour OGTT. Results: Among the study population, the mean age and BMI was 26.04±4.50 and 24.08±3.30 respectively. Out of 282 patients, 8 cases (2.83%) were found to have abnormal non-fasting 75-g OGCT and 4 cases (1.41%) had abnormal WHO 2-hour OGTT. Paired t test was employed to examine the difference of blood glucose level of the tests. There was statistically significant difference (p<0.001) between the tests. The Sensitivity, specificity, positive predictive value and negative predictive value of oral glucose challenge test was 25%, 97.48%, 12.5% and 98.90% respectively. The non- fasting 75-g OGCT was able to detect only 25% of the cases. Conclusions: Though the non-fasting 75-g OGCT test is cost effective and more compliant to pregnant women, the present report suggests that it cannot be used as a single step screening and diagnostic test because of its low sensitivity. However, it is an adequate alternative for screening test in resources limited areas.

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