Department of Obstetrics, Gynecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal.
Int J Gynaecol Obstet. 2019 Oct;147(1):108-114. doi: 10.1002/ijgo.12923. Epub 2019 Jul 29.
To evaluate the incidence of abnormal third trimester oral glucose tolerance tests (OGTT) results in non-diabetic women and to compare the obstetric and neonatal outcomes with those of women with normal OGTT results.
Women with third trimester singleton pregnancies with negative gestational diabetes test results earlier in their pregnancy were enrolled into an observational prospective study at a tertiary care hospital between June 1, 2014 and September 30, 2017. All underwent an additional 75 g OGTT between 32 and 36 weeks and were classified as having normal or abnormal results. Healthcare professionals were blinded to the results. Pregnancy and perinatal outcomes were compared.
Four hundred and sixty-seven women agreed to participate and 334 fulfilled the inclusion criteria. Forty-five (13.5%) had an abnormal third trimester OGTT result. In this group, post-term induction of labor was more frequent (70.6% vs 38.1%, adjusted odds ratio (aOR) 4.28, 95% confidence interval (CI) 1.33-13.77, P=0.015) as was cesarean delivery (31.1% vs 15.2%, aOR 2.57, 95% CI 1.14-5.81, P=0.023), regardless of surgery indication. Macrosomia was more common, but not significantly after adjusting for confounders (17.8% vs 4.2%, aOR 3.80, 95% CI 0.60-24.17, P=0.157). No other significant differences were found.
Post-term induction of labor and cesarean delivery were more frequent in women with an abnormal third trimester OGTT result, but there was no increased risk of serious maternal or perinatal adverse outcomes.
评估非糖尿病女性妊娠晚期口服葡萄糖耐量试验(OGTT)异常结果的发生率,并比较异常 OGTT 结果与正常 OGTT 结果孕妇的产科和新生儿结局。
本研究为前瞻性观察性研究,纳入 2014 年 6 月 1 日至 2017 年 9 月 30 日期间在一家三级保健医院就诊的妊娠中期妊娠糖尿病检查结果阴性的单胎妊娠晚期孕妇。所有孕妇均在 32-36 周时进行了额外的 75g OGTT,并根据结果分为正常和异常组。医务人员对结果不了解。比较两组孕妇的妊娠和围产儿结局。
共有 467 名孕妇同意参与研究,其中 334 名孕妇符合纳入标准。45 名(13.5%)孕妇 OGTT 异常。该组孕妇中,延期产程的催产率较高(70.6% vs 38.1%,调整优势比(aOR)4.28,95%置信区间(CI)1.33-13.77,P=0.015),剖宫产率也较高(31.1% vs 15.2%,aOR 2.57,95% CI 1.14-5.81,P=0.023),但不论手术指征如何。校正混杂因素后,巨大儿的发生率较高,但差异无统计学意义(17.8% vs 4.2%,aOR 3.80,95% CI 0.60-24.17,P=0.157)。
妊娠晚期 OGTT 异常的孕妇中,延期产程催产和剖宫产的发生率较高,但母婴不良结局的风险并未增加。