The effect of treatment on pregnancy outcomes in women with one elevated oral glucose tolerance test value.

OBJECTIVE

The aim of the study was to evaluate whether dietary intervention could reduce maternal and perinatal morbidity in pregnancies with one elevated 100 g oral glucose tolerance test (OGTT) value.

MATERIAL AND

METHODS

The study was conducted among patients with positive 50 g glucose challenge test (GCT) and one elevated 100 g OGTT value. Plasma glucose value of 140 mg/dL was used as the threshold to define an abnormal GCT result. Carpenter and Coustan criteria were used to evaluate the OGTT results. Seventy-four women with normal GCT values comprised group I. Ninety-nine women with one elevated 100 g OGTT value who were given a caloric diet and 102 women with one elevated OGTT value in group III who received antenatal care with no special diet were randomly assigned to groups II and III, respectively. All women were followed up until the end of pregnancy. Poor maternal outcome was defined as: cesarean delivery performed due to cephalopelvic disproportion, failure to progress or fetal distress, preeclampsia, and/or preterm labor. Poor perinatal outcome was defined as: small for gestational age, large for gestational age or admission to a neonatal intensive care unit. The groups were compared in terms of maternal and perinatal outcomes.

RESULTS

The rates of macrosomia and large for gestational age incidence were significantly higher in group III as compared to groups I and II. When we examined the multivariate effects of the risk factors considered to be predictive of poor maternal outcomes, group III was the only statistically significant risk factor (OR=3.90, 95% CI:1.95- 7.84; p=<0.001). In terms of poor perinatal outcome, one elevated OGTT value (group III) was the only significant risk factor (OR=2.92, 95% CI:1.56-5.46; p=<0.001).

CONCLUSION

Women with one elevated OGTT value benefit from a structured program of diet therapy aimed to reduce adverse maternal and perinatal outcomes.