Oral or Poster Presentation
Concurrent Session 2B - Maternal Fetal Medicine
Introduction: To analyze the characteristics of abnormal oral glucose tolerance test (OGTT) values at gestational diabetes mellitus (GDM) diagnosis and their associations with clinical characteristics.
Methods: A retrospective cohort study of women with a first diagnosis of GDM between 2014-2018.GDM diagnosis was based on a pathological 50g glucose challenge screening (GCT ≥140mg/dl) followed by abnormal 75g OGTT during 24-28 weeks of gestation.Patients were categorized into groups according to number of abnormal values and according to the fasting glucose profile (with normal and abnormal fasting glucose level): one abnormal value, two abnormal values and three abnormal values.Primary outcome included either requirement of pharmacotherapy or large for gestational age defined as birth weight above the 90th percentile for gestational age).
Results: Overall, 885 patients were eligible. Of them, 275, 420 and 190 women had one, two and three abnormal values, respectively (Table 1). Rates of previous GDM history, ethnicity (not shown) and gestational age at GDM diagnosis were similar. Women with abnormal fasting levels had higher pre-pregnancy BMI level, regardless having 1 or 2 abnormal OGTT values. Neonatal outcome was similar among the groups (not shown).
Women with abnormal fasting level tend to require pharmacotherapy and had higher LGA rates, regardless of the number of abnormal values (Table 1). The rates of pharmacotherapy requirement, LGA and composite outcome were comparable in cases of abnormal fasting levels, in cases of one, two and even three abnormal values on OGTT.Logistic regression analysis adjusting for maternal age and pre-pregnancy BMI, revealed significant association between abnormal fasting glucose values and of pharmacotherapy requirement, LGA and composite outcome, for both a single abnormal value and two abnormal values (Figure 1).
Conclusion: Abnormal fasting levels on OGTT constitute a significant predictive factor for adverse outcome in GDM pregnancies regardless the number of abnormal values. This effect was not mediated by pre-pregnancy BMI.