Cheng Yvonne W, McLaughlin G Blake, Esakoff Tania F, Block-Kurbisch Ingrid, Caughey Aaron B
Division of Perinatal Medicine and Genetics, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California 94143-0132, USA.
J Matern Fetal Neonatal Med. 2007 Dec;20(12):903-8. doi: 10.1080/14767050701739384.
To examine whether women with an 1-hour 50-g glucose challenge test (GCT) for gestational diabetes mellitus (GDM) between 120 and 140 mg/dL and >or=140 mg/dL are at risk of perinatal complications.
A retrospective cohort study of women with singleton pregnancies screened for GDM between 1988 and 2001 with a 1-hour 50-g GCT. Values of GCT were stratified into four subgroups: <120, 120-129, 130-139, and >or=140 mg/dL. Perinatal outcomes were compared using the Chi-square test and multivariable logistic regression analysis.
There were 13 901 women meeting the study criteria. Compared to women with a GCT of <120 mg/dL, women with a GCT of 130-139 mg/dL and >or=140 mg/dL were more likely to have preeclampsia and operative vaginal or cesarean deliveries. Neonates born to women with a GCT of 130-139 mg/dL also had higher odds of having a 5-minute Apgar score <7 (odds ratio (OR) = 1.51, 95% confidence interval (CI) 1.01-2.29), shoulder dystocia (OR = 2.02, 95% CI 1.16-2.55), birth trauma (OR = 1.47, 95% CI 1.06-2.02), and composite morbidity (OR = 1.25, 95% CI 1.03-1.51). Women with a GCT of >or=140 mg/dL had higher odds of macrosomia (OR = 1.32, 95% CI 1.13-1.54) and shoulder dystocia (OR = 1.68, 95% CI 1.11-2.55).
Women with GCT results of 130-139 mg/dL appear to be at increased risk for perinatal morbidity. Thus, utilizing a diagnostic test in women with a GCT above 130 mg/dL should be considered.
探讨妊娠糖尿病（GDM）1小时50克葡萄糖耐量试验（GCT）结果在120至140mg/dL以及≥140mg/dL的女性是否存在围产期并发症风险。
一项回顾性队列研究，研究对象为1988年至2001年间接受1小时50克GCT筛查GDM的单胎妊娠女性。GCT值被分为四个亚组：<120、120 - 129、130 - 139以及≥140mg/dL。采用卡方检验和多变量逻辑回归分析比较围产期结局。
共有13901名女性符合研究标准。与GCT<120mg/dL的女性相比，GCT为130 - 139mg/dL以及≥140mg/dL的女性更易发生先兆子痫、阴道助产或剖宫产。GCT为130 - 139mg/dL的女性所生新生儿5分钟阿氏评分<7分（优势比（OR）=1.51，95%置信区间（CI）1.01 - 2.29）、肩难产（OR = 2.02，95%CI 1.16 - 2.55）、产伤（OR = 1.47，95%CI 1.06 - 2.02）以及复合发病率（OR = 1.25，95%CI 1.03 - 1.51）的几率也更高。GCT≥140mg/dL的女性巨大儿（OR = 1.32，95%CI 1.13 - 1.54）和肩难产（OR = 1.68，95%CI 1.11 - 2.55）的几率更高。
GCT结果为130 - 139mg/dL的女性围产期发病风险似乎增加。因此，对于GCT高于130mg/dL的女性应考虑采用诊断性检查。
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