Relationship between 1-hour glucose challenge test results and perinatal outcomes

Dana Figueroa*, Mark B. Landon, Lisa Mele, Catherine Y. Spong, Susan M. Ramin, Brian Casey, Ronald J. Wapner, Michael W. Varner, John M. Thorp, Anthony Sciscione, Patrick Catalano, Margaret Harper, George Saade, Steve N. Caritis, Yoram Sorokin, Alan M. Peaceman, Jorge E. Tolosa

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVE: To estimate the relationship between 1-hour 50 g glucose challenge test values and perinatal outcomes. METHODS: This was a secondary analysis of data from a multicenter treatment trial of mild gestational diabetes mellitus. Women with glucose challenge test values of 135-199 mg/dL completed a 3-hour oral glucose tolerance test. Mild gestational diabetes mellitus was defined as fasting glucose less than 95 mg/dL and two or more abnormal oral glucose tolerance test values: 1-hour 180 mg/dL or more; 2-hour 155 mg/dL or more; and 3-hour 140 mg/dL or more. Our study included untreated women with glucose challenge test values of 135-139 mg/dL and 140-199 mg/dL and a comparison group with values less than 120 mg/dL. Primary outcomes included a perinatal composite (stillbirth, neonatal death, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and birth trauma), large for gestational age (LGA, birth weight above the 90th percentile based on sex-specific and race-specific norms), and macrosomia (greater than 4,000 g). RESULTS: There were 436 women with glucose challenge test values less than 120 mg/dL and 1,403 with values of 135 mg/dL or more (135-139, n=135; 140-199, n=1,268). The composite perinatal outcome occurred in 25.6% of those with glucose challenge test values less than 120 mg/dL compared with 21.1% for values of 135-139 mg/dL and 35.3% for values of 140-199 mg/dL. Rates of LGA by group were 6.6%, 6.8%, and 12.4%, respectively. Rates of macrosomia by group were 7.8%, 6.1%, and 12.1%, respectively. Compared with glucose challenge test values less than 120 mg/dL, the adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for values of 140-199 mg/dL were 1.48 (1.14-1.93) for the composite outcome, 1.97 (1.29-3.11) for LGA, and 1.61 (1.07-2.49) for macrosomia. For glucose challenge test values of 135-139 mg/dL, adjusted ORs and 95% CIs were 0.75 (0.45-1.21), 1.04 (0.44-2.24), and 0.75 (0.30-1.66), respectively. The subcategories with glucose challenge test values of 140-144 mg/dL and 145-149 mg/dL also were associated with an increase in selected outcomes when compared with those with values less than 120 mg/dL. CONCLUSIONS: Glucose challenge test values of 135-139 mg/dL were not associated with adverse outcomes compared with values less than 120 mg/dL; however, glucose challenge test values of 140 mg/dL or more were associated with an increase in odds of the composite perinatal outcome, LGA, and macrosomia.

Original languageEnglish (US)
Pages (from-to)1241-1247
Number of pages7
JournalObstetrics and gynecology
Volume121
Issue number6
DOIs
StatePublished - Jun 1 2013

Fingerprint

Glucose
Gestational Diabetes
Glucose Tolerance Test
Odds Ratio
Neonatal Hyperbilirubinemia
Confidence Intervals
Stillbirth
Hyperinsulinism
Hypoglycemia
Birth Weight
Gestational Age
Multicenter Studies
Fasting
Parturition
Wounds and Injuries

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Figueroa, D., Landon, M. B., Mele, L., Spong, C. Y., Ramin, S. M., Casey, B., ... Tolosa, J. E. (2013). Relationship between 1-hour glucose challenge test results and perinatal outcomes. Obstetrics and gynecology, 121(6), 1241-1247. https://doi.org/10.1097/AOG.0b013e31829277f5
Figueroa, Dana ; Landon, Mark B. ; Mele, Lisa ; Spong, Catherine Y. ; Ramin, Susan M. ; Casey, Brian ; Wapner, Ronald J. ; Varner, Michael W. ; Thorp, John M. ; Sciscione, Anthony ; Catalano, Patrick ; Harper, Margaret ; Saade, George ; Caritis, Steve N. ; Sorokin, Yoram ; Peaceman, Alan M. ; Tolosa, Jorge E. / Relationship between 1-hour glucose challenge test results and perinatal outcomes. In: Obstetrics and gynecology. 2013 ; Vol. 121, No. 6. pp. 1241-1247.
@article{8b02ae9d31784514a208d1c777a14b9e,
title = "Relationship between 1-hour glucose challenge test results and perinatal outcomes",
abstract = "OBJECTIVE: To estimate the relationship between 1-hour 50 g glucose challenge test values and perinatal outcomes. METHODS: This was a secondary analysis of data from a multicenter treatment trial of mild gestational diabetes mellitus. Women with glucose challenge test values of 135-199 mg/dL completed a 3-hour oral glucose tolerance test. Mild gestational diabetes mellitus was defined as fasting glucose less than 95 mg/dL and two or more abnormal oral glucose tolerance test values: 1-hour 180 mg/dL or more; 2-hour 155 mg/dL or more; and 3-hour 140 mg/dL or more. Our study included untreated women with glucose challenge test values of 135-139 mg/dL and 140-199 mg/dL and a comparison group with values less than 120 mg/dL. Primary outcomes included a perinatal composite (stillbirth, neonatal death, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and birth trauma), large for gestational age (LGA, birth weight above the 90th percentile based on sex-specific and race-specific norms), and macrosomia (greater than 4,000 g). RESULTS: There were 436 women with glucose challenge test values less than 120 mg/dL and 1,403 with values of 135 mg/dL or more (135-139, n=135; 140-199, n=1,268). The composite perinatal outcome occurred in 25.6{\%} of those with glucose challenge test values less than 120 mg/dL compared with 21.1{\%} for values of 135-139 mg/dL and 35.3{\%} for values of 140-199 mg/dL. Rates of LGA by group were 6.6{\%}, 6.8{\%}, and 12.4{\%}, respectively. Rates of macrosomia by group were 7.8{\%}, 6.1{\%}, and 12.1{\%}, respectively. Compared with glucose challenge test values less than 120 mg/dL, the adjusted odds ratios (ORs) (95{\%} confidence intervals [CIs]) for values of 140-199 mg/dL were 1.48 (1.14-1.93) for the composite outcome, 1.97 (1.29-3.11) for LGA, and 1.61 (1.07-2.49) for macrosomia. For glucose challenge test values of 135-139 mg/dL, adjusted ORs and 95{\%} CIs were 0.75 (0.45-1.21), 1.04 (0.44-2.24), and 0.75 (0.30-1.66), respectively. The subcategories with glucose challenge test values of 140-144 mg/dL and 145-149 mg/dL also were associated with an increase in selected outcomes when compared with those with values less than 120 mg/dL. CONCLUSIONS: Glucose challenge test values of 135-139 mg/dL were not associated with adverse outcomes compared with values less than 120 mg/dL; however, glucose challenge test values of 140 mg/dL or more were associated with an increase in odds of the composite perinatal outcome, LGA, and macrosomia.",
author = "Dana Figueroa and Landon, {Mark B.} and Lisa Mele and Spong, {Catherine Y.} and Ramin, {Susan M.} and Brian Casey and Wapner, {Ronald J.} and Varner, {Michael W.} and Thorp, {John M.} and Anthony Sciscione and Patrick Catalano and Margaret Harper and George Saade and Caritis, {Steve N.} and Yoram Sorokin and Peaceman, {Alan M.} and Tolosa, {Jorge E.}",
year = "2013",
month = "6",
day = "1",
doi = "10.1097/AOG.0b013e31829277f5",
language = "English (US)",
volume = "121",
pages = "1241--1247",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

Figueroa, D, Landon, MB, Mele, L, Spong, CY, Ramin, SM, Casey, B, Wapner, RJ, Varner, MW, Thorp, JM, Sciscione, A, Catalano, P, Harper, M, Saade, G, Caritis, SN, Sorokin, Y, Peaceman, AM & Tolosa, JE 2013, 'Relationship between 1-hour glucose challenge test results and perinatal outcomes', Obstetrics and gynecology, vol. 121, no. 6, pp. 1241-1247. https://doi.org/10.1097/AOG.0b013e31829277f5

Relationship between 1-hour glucose challenge test results and perinatal outcomes. / Figueroa, Dana; Landon, Mark B.; Mele, Lisa; Spong, Catherine Y.; Ramin, Susan M.; Casey, Brian; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M.; Sciscione, Anthony; Catalano, Patrick; Harper, Margaret; Saade, George; Caritis, Steve N.; Sorokin, Yoram; Peaceman, Alan M.; Tolosa, Jorge E.

In: Obstetrics and gynecology, Vol. 121, No. 6, 01.06.2013, p. 1241-1247.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship between 1-hour glucose challenge test results and perinatal outcomes

AU - Figueroa, Dana

AU - Landon, Mark B.

AU - Mele, Lisa

AU - Spong, Catherine Y.

AU - Ramin, Susan M.

AU - Casey, Brian

AU - Wapner, Ronald J.

AU - Varner, Michael W.

AU - Thorp, John M.

AU - Sciscione, Anthony

AU - Catalano, Patrick

AU - Harper, Margaret

AU - Saade, George

AU - Caritis, Steve N.

AU - Sorokin, Yoram

AU - Peaceman, Alan M.

AU - Tolosa, Jorge E.

PY - 2013/6/1

Y1 - 2013/6/1

N2 - OBJECTIVE: To estimate the relationship between 1-hour 50 g glucose challenge test values and perinatal outcomes. METHODS: This was a secondary analysis of data from a multicenter treatment trial of mild gestational diabetes mellitus. Women with glucose challenge test values of 135-199 mg/dL completed a 3-hour oral glucose tolerance test. Mild gestational diabetes mellitus was defined as fasting glucose less than 95 mg/dL and two or more abnormal oral glucose tolerance test values: 1-hour 180 mg/dL or more; 2-hour 155 mg/dL or more; and 3-hour 140 mg/dL or more. Our study included untreated women with glucose challenge test values of 135-139 mg/dL and 140-199 mg/dL and a comparison group with values less than 120 mg/dL. Primary outcomes included a perinatal composite (stillbirth, neonatal death, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and birth trauma), large for gestational age (LGA, birth weight above the 90th percentile based on sex-specific and race-specific norms), and macrosomia (greater than 4,000 g). RESULTS: There were 436 women with glucose challenge test values less than 120 mg/dL and 1,403 with values of 135 mg/dL or more (135-139, n=135; 140-199, n=1,268). The composite perinatal outcome occurred in 25.6% of those with glucose challenge test values less than 120 mg/dL compared with 21.1% for values of 135-139 mg/dL and 35.3% for values of 140-199 mg/dL. Rates of LGA by group were 6.6%, 6.8%, and 12.4%, respectively. Rates of macrosomia by group were 7.8%, 6.1%, and 12.1%, respectively. Compared with glucose challenge test values less than 120 mg/dL, the adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for values of 140-199 mg/dL were 1.48 (1.14-1.93) for the composite outcome, 1.97 (1.29-3.11) for LGA, and 1.61 (1.07-2.49) for macrosomia. For glucose challenge test values of 135-139 mg/dL, adjusted ORs and 95% CIs were 0.75 (0.45-1.21), 1.04 (0.44-2.24), and 0.75 (0.30-1.66), respectively. The subcategories with glucose challenge test values of 140-144 mg/dL and 145-149 mg/dL also were associated with an increase in selected outcomes when compared with those with values less than 120 mg/dL. CONCLUSIONS: Glucose challenge test values of 135-139 mg/dL were not associated with adverse outcomes compared with values less than 120 mg/dL; however, glucose challenge test values of 140 mg/dL or more were associated with an increase in odds of the composite perinatal outcome, LGA, and macrosomia.

AB - OBJECTIVE: To estimate the relationship between 1-hour 50 g glucose challenge test values and perinatal outcomes. METHODS: This was a secondary analysis of data from a multicenter treatment trial of mild gestational diabetes mellitus. Women with glucose challenge test values of 135-199 mg/dL completed a 3-hour oral glucose tolerance test. Mild gestational diabetes mellitus was defined as fasting glucose less than 95 mg/dL and two or more abnormal oral glucose tolerance test values: 1-hour 180 mg/dL or more; 2-hour 155 mg/dL or more; and 3-hour 140 mg/dL or more. Our study included untreated women with glucose challenge test values of 135-139 mg/dL and 140-199 mg/dL and a comparison group with values less than 120 mg/dL. Primary outcomes included a perinatal composite (stillbirth, neonatal death, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and birth trauma), large for gestational age (LGA, birth weight above the 90th percentile based on sex-specific and race-specific norms), and macrosomia (greater than 4,000 g). RESULTS: There were 436 women with glucose challenge test values less than 120 mg/dL and 1,403 with values of 135 mg/dL or more (135-139, n=135; 140-199, n=1,268). The composite perinatal outcome occurred in 25.6% of those with glucose challenge test values less than 120 mg/dL compared with 21.1% for values of 135-139 mg/dL and 35.3% for values of 140-199 mg/dL. Rates of LGA by group were 6.6%, 6.8%, and 12.4%, respectively. Rates of macrosomia by group were 7.8%, 6.1%, and 12.1%, respectively. Compared with glucose challenge test values less than 120 mg/dL, the adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for values of 140-199 mg/dL were 1.48 (1.14-1.93) for the composite outcome, 1.97 (1.29-3.11) for LGA, and 1.61 (1.07-2.49) for macrosomia. For glucose challenge test values of 135-139 mg/dL, adjusted ORs and 95% CIs were 0.75 (0.45-1.21), 1.04 (0.44-2.24), and 0.75 (0.30-1.66), respectively. The subcategories with glucose challenge test values of 140-144 mg/dL and 145-149 mg/dL also were associated with an increase in selected outcomes when compared with those with values less than 120 mg/dL. CONCLUSIONS: Glucose challenge test values of 135-139 mg/dL were not associated with adverse outcomes compared with values less than 120 mg/dL; however, glucose challenge test values of 140 mg/dL or more were associated with an increase in odds of the composite perinatal outcome, LGA, and macrosomia.

UR - http://www.scopus.com/inward/record.url?scp=84879070586&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879070586&partnerID=8YFLogxK

U2 - 10.1097/AOG.0b013e31829277f5

DO - 10.1097/AOG.0b013e31829277f5

M3 - Article

VL - 121

SP - 1241

EP - 1247

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 6

ER -