The 50-g glucose challenge test and pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes

Abstract 

Objective

To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM).

Methods

GCT was positive if the 1-hour plasma glucose level was ≥7.2 mmol/L. GDM was diagnosed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive, and 168 had GDM. Pregnancy outcomes were extracted from hospital records. Multivariable logistic regression analysis was performed with GCT negative women as the reference group.

Results

GCT false-positive status was associated with preterm birth (adjusted odds ratio [AOR] 2.1; 95% CI, 1.2–3.7) and postpartum hemorrhage (AOR 1.7; 95% CI, 1.0–2.7). GDM was associated with labor induction (AOR 5.0; 95% CI, 3.3–7.5), cesarean delivery (AOR 2.2; 95% CI, 1.6–3.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.2–3.7), and neonatal macrosomia (AOR 2.5; 95% CI, 1.0–6.0).

Conclusion

GCT false-positive women had an increased likelihood of an adverse pregnancy outcome. The role and threshold of the GCT needs re-evaluation.

Keywords: Cesarean delivery, Gestational diabetes, Glucose challenge test, Labor induction, Macrosomia