How Can We Adopt the Glucose Tolerance Test to Facilitate Predicting
Pregnancy Outcome in Gestational Diabetes Mellitus?
Abstract
Objective: To investigate how 100-g oral glucose tolerance test (OGTT)
results can be used to predict adverse pregnancy outcomes in pregnant
women. Design: Retrospective cohort. Setting and sample: Single-center
with 1,059 pregnant women Main outcome measures: A composite of adverse
pregnancy outcomes including preterm birth, macrosomia, large for
gestational age, low “appearance, pulse, grimace, activity, and
respiration” score at 1 min, and pregnancy-induced hypertension.
Methods: We compared the risk of adverse pregnancy outcomes according to
OGTT patterns by latent profile analysis (LPA), numbers to meet the OGTT
criteria, and area under the curve (AUC) of the OGTT graph. Results:
Overall, 257 participants were diagnosed with GDM, with a median age of
34 years. An LPA led to three different clusters of OGTT patterns,
however, there were no significant associations between the clusters and
adverse pregnancy outcomes after adjusting for confounders.
Notwithstanding, the risk of adverse pregnancy outcome increased with an
increase in number to meet the OGTT criteria (p for trend = 0.011); odds
ratios in a full adjustment model were 1.27 (0.72–2.23), 2.16
(1.21–3.85), and 2.32 (0.66–8.15) in those meeting the 2, 3, and 4
criteria, respectively. The AUCs of the OGTT curves also distinguished
the patients at risk of adverse pregnancy outcomes; the larger the AUC,
the higher the risk (p for trend = 0.007). Conclusions: The total number
of abnormal values and calculated AUCs for the 100-g OGTT may facilitate
precise management of patients with GDM by predicting adverse pregnancy
outcomes.