50-Gram glucose challenge test: is it indicative of outcomes in women without gestational diabetes mellitus?

Abstract

Objective. To examine whether the 50-gram glucose challenge test (GCT) is associated with perinatal outcomes in women without gestational diabetes mellitus (GDM).

Methods. This is a retrospective cohort study of 13,789 women who received the GCT and did not have a diagnosis of GDM at the University of California, San Francisco UCSF. GCT values were categorized and examined as predictors of perinatal morbidity using chi-square test and multivariable logistic regression analyses adjusting for maternal characteristics.

Results. In women with an elevated GCT but without GDM, the odds of preeclampsia, cesarean delivery, and elevated birth weight were increased. The odds of large-for-gestational age status were increased with aOR 2.0 (95% CI 1.38–2.90) in the 160–179 mg/dl group. The odds of shoulder dystocia was increased with aOR 3.35 (CI 1.03–10.88) in the ≥180mg/dl group.

Conclusion. In women without GDM, elevated 50-gram GCT values were associated with higher odds of perinatal morbidity. These findings further support evidence that impaired glucose tolerance is a continuum with possible associated adverse outcomes even at mild ranges; additional research is required to investigate appropriate interventions for women with abnormal screens for GDM.

Keywords:

• Gestational diabetes mellitus
• glucose challenge test
• perinatal outcomes
• screening

Acknowledgements

Dr. Caughey is supported by the Robert Wood Johnson Foundation as Physician Faculty Scholar RWJF-61535. Dr. Yvonne W. Cheng is supported by the UCSF Women's Reproductive Health Research Career Development Award, NIH, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12 HD001262).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.