1 Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, the Graduate School of Medicine of Dongguk University , Goyang, Republic of Korea.
2 Institute of Women's Life Medical Science, Yonsei University College of Medicine , Seoul, Republic of Korea.
J Womens Health (Larchmt). 2018 Jun;27(6):801-807. doi: 10.1089/jwh.2017.6579. Epub 2018 Jan 11.
The implications of low values on the 50 g glucose challenge test (GCT) in pregnancy are not clearly defined. Few studies have evaluated the influence of maternal low GCT values on obstetrical outcomes. This study aimed to compare pregnancy outcomes between women with low 50 g GCT values and those with normal values.
Women undergoing gestational diabetes mellitus screening at 24-28 weeks of gestational age between January 2010 and December 2016 were retrospectively evaluated. Women with multifetal pregnancies, prepregnancy type I or II diabetes, GCT performed before 24 or after 28 weeks of gestational age, and women undergoing multiple GCTs in the same pregnancy were excluded. Low GCT values and normal GCT values were defined as ≤85 mg/dL and 86-130 mg/dL, respectively.
Of 3875 screened subjects, 519 (13.4%) women were included in the low GCT group and 3356 (86.6%) in the normal GCT group. Low GCT women had a significantly higher rate of small for gestational age (SGA) infants than normal GCT women (10.8% vs. 7.9%, p = 0.02). Cesarean section and postpartum hemorrhage (PPH) were less frequent in low GCT women than in normal women (32.6% vs. 42.8%, p < 0.01 and 0.2% vs. 1.2%, p = 0.03, respectively). Low GCT women had a 1.38-fold increased risk of bearing SGA infants (95% confidence intervals: 1.01-1.88, p = 0.04).
Rate of SGA infants was significantly higher and cesarean delivery and PPH rates were significantly lower in women with low GCT values. Low GCT values were independently associated with an increased risk of SGA.
妊娠 50g 葡萄糖挑战试验（GCT）低值的意义尚不清楚。很少有研究评估母体低 GCT 值对产科结局的影响。本研究旨在比较低值和正常 GCT 值的妊娠结局。
回顾性分析 2010 年 1 月至 2016 年 12 月 24-28 周行妊娠期糖尿病筛查的孕妇。排除多胎妊娠、孕前 I 型或 II 型糖尿病、GCT 检测时间早于 24 周或晚于 28 周、同一孕期行多次 GCT 检测的孕妇。低值和正常 GCT 值定义为≤85mg/dL 和 86-130mg/dL。
3875 例筛查对象中，519 例（13.4%）孕妇入低值 GCT 组，3356 例（86.6%）孕妇入正常 GCT 组。低值 GCT 组胎儿小于胎龄儿（SGA）的发生率显著高于正常 GCT 组（10.8% vs. 7.9%，p=0.02）。低值 GCT 组剖宫产和产后出血（PPH）的发生率显著低于正常 GCT 组（32.6% vs. 42.8%，p<0.01；0.2% vs. 1.2%，p=0.03）。低值 GCT 组发生 SGA 的风险增加 1.38 倍（95%置信区间：1.01-1.88，p=0.04）。
低值 GCT 值的孕妇 SGA 发生率显著升高，剖宫产和 PPH 发生率显著降低。低值 GCT 值与 SGA 风险增加独立相关。
