Pregnancy and neonatal adverse outcomes in women with gestational diabetes mellitus diagnosed by a 50-g glucose challenge test level ≥ 200 mg/dl compared withtest results using the 100-g oral glucose tolerance test and carpenter-coustan criteria

• Main Authors: Sunisa Kannawat, Saifon Chawanpaiboon, Dittakarn Boriboonhirunsarn
• Other Authors: Siriraj Hospital
• Format: Article
• Published: 2022
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/78241
• Institution: Mahidol University

Objectives: To compare pregnancy and neonatal outcomes between women with gestational diabetes mellitus (GDM) diagnosed by using the 100-g oral glucose tolerance test (OGTT) with the Carpenter-Coustan criteria and 50-g glucose challenge test (GCT) ≥ 200 mg/dl. Materials and Methods: A retrospective cohort study was conducted based on the medical records of all GDM women who had delivered at Siriraj Hospital, Thailand, between July 2015 and April 2018. The rate of occurrence of a large for gestational age (LGA) neonate (> 90th percentile) was a primary outcome. Secondary outcomes were the rates of preterm delivery, cesarean section, small-for-gestational age neonate (< 10th percentile), fetal macrosomia, fetal hypoglycemia, neonatal intensive care unit admission, and birth asphyxia. Results: Of the 970 GDM women included in the study, 776 women were diagnosed by 100-g OGTT with the Carpenter-Coustan criteria (Group 1) and 194 women were diagnosed by a 50-g GCT level ≥ 200 mg/dl (Group 2). There were no significant differences in baseline characteristics, pregnancy, and neonatal outcome in the two groups. The rates of LGA in the two groups were 25.8% and 22.7% in group 1 and group 2, respectively (p = 0.154). However, the gestational age at diagnosis and the multipara rate were 21.5 weeks and 53.4% in group 1, and 10.9 weeks and 67.5% in group 2 (p < 0.001), respectively. Conclusion: There were no significant differences in baseline characteristics and pregnancy and neonatal outcome in both groups. However, gestational age at diagnosis in the 50-g GCT ≥ 200 mg/dl group was earlier than in the 100-g OGTT with the Carpenter–Coustan criteria group. There were limitations of the study including the controlling of all the confounding factors which were how well to Hemoglobin A1C (HbA1C) control and intrapartum blood sugar control in this study.