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Elevated Glucose Challenge Test in a Nondiabetic Index Pregnancy and Gestational Diabetes in a Subsequent Pregnancy
| Content Provider | Scilit |
|---|---|
| Author | Reyes, Samantha De Los Dude, Annie Adams, Marci Plunkett, Beth Hirsch, Emmet |
| Copyright Year | 2021 |
| Description | Objective The aim of this study was to evaluate whether a 1-hour glucose challenge test (GCT) ≥140 mg/dL in a nondiabetic index pregnancy is associated with the development of gestational diabetes mellitus (GDM) in a subsequent pregnancy. Study Design We performed a retrospective cohort study from a single institution from June 2009 to December 2018. Women with a nondiabetic index singleton gestation who underwent a 1-hour GCT at 24 to 28 weeks and had a successive singleton delivery were included. GDM was defined by a 1-hour GCT of ≥ 200 mg/dL, ≥2 of 4 elevated values on a 3-hour GCT, or a diagnosis of GDM defined by International Classification of Disease codes in the electronic medical record. Univariable analyses were performed to evaluate the associations between an elevated 1-hour GCT result in the index pregnancy, maternal characteristics, and the development of GDM in the subsequent pregnancy. Variables found to be significant (p < 0.05) were included in multivariable analysis. Results A total of 2,423 women were included. Of these, 340 (14.0%) had an elevated 1-hour GCT in the index pregnancy. Women with an elevated 1-hour GCT in the index pregnancy compared with those without were significantly more likely to be older, married, privately insured, of Hispanic ethnicity or Asian race, chronically hypertensive, have a higher body mass index (BMI), have a shorter inter-pregnancy interval, and to develop GDM in the subsequent pregnancy (14.4 vs. 3.3%, p < 0.001). In multivariable analysis, an elevated 1-hour GCT (adjusted odds ratio [aOR]: 4.54, 95% confidence interval [CI]: 3.02–6.81), first-trimester BMI ≥30 $kg/m^{2}$ in the index pregnancy (aOR: 3.10, 95% CI: 2.03–4.71), Asian race (aOR: 2.96, 95% CI: 1.70–5.12), Hispanic ethnicity (aOR: 2.11, 95% CI: 1.12–4.00), and increasing age (aOR: 1.07, 95% CI: 1.02–1.12) were significantly associated with an increased risk of GDM in the subsequent pregnancy. Conclusion An elevated 1-hour GCT in a nondiabetic index pregnancy is associated with a fourfold increased risk of GDM in a subsequent pregnancy. Key Points Received: 13 July 2020 Accepted: 05 March 2021 Publication Date: 27 May 2021 (online) © 2021. Thieme. All rights reserved. Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA |
| Related Links | http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1729878.pdf |
| Ending Page | 1121 |
| Page Count | 5 |
| Starting Page | 1117 |
| ISSN | 07351631 |
| e-ISSN | 10988785 |
| DOI | 10.1055/s-0041-1729878 |
| Journal | American Journal of Perinatology |
| Issue Number | 11 |
| Volume Number | 38 |
| Language | English |
| Publisher | Georg Thieme Verlag KG |
| Publisher Date | 2021-05-27 |
| Access Restriction | Open |
| Subject Keyword | Journal: American Journal of Perinatology Obstetrics and Gynecology Elevated Glucose Tolerance Screening Tests Gestational Diabetes Pregnancy Outcomes Risk Factors for Gestational Diabetes |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pediatrics, Perinatology and Child Health Obstetrics and Gynecology |
