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Women With Impaired Glucose Tolerance During Pregnancy Have Significantly
Poor Pregnancy Outcomes
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Xilin Yang, PHD, Department of Rural Health, University of Melbourne,
Melbourne, Australia
OBJECTIVE This article tests the hypothesis that women with impaired glucose
tolerance (IGT) have the same pregnancy outcomes as those of their
counterparts with normal glucose tolerance.
RESEARCH DESIGN AND METHODS From December 1998 to December 1999, 84 of 90
antenatal care base units (ACBUs) under the Tianjin Antenatal Care Network in
China participated in the first screening program for gestational diabetes
mellitus (GDM). A total of 9,471 pregnant women under the care of
participating ACBUs were screened. Of the women screened, 154 were positive
for IGT. Of the 154 women, 102 opted for conventional obstetric care. The
comparison group was 302 women of normal glucose tolerance (NGT). The initial
screening consisted of a 50-g 1-h glucose test, and was carried out at 26-30
gestational weeks. Women with a serum glucose 7.8 mmol/l were followed up
with a 75-g 2-h oral glucose tolerance test. The World Health Organizationšs
diagnostic criteria for GDM were used.
RESULTS Women with IGT were at increased risk for premature rupture of
membranes (P-ROM) (odds ratio [OR] 10.07; 95% CI 2.90-34.93); preterm birth
(6.42; 1.46-28.34); breech presentation (3.47; 1.11-10.84); and high birth
weight (90th percentile or 4,000 g) (2.42; 1.07-5.46); adjusting for maternal
age, pregravid BMI, hospital levels, and other confounding factors.
CONCLUSIONS The presence of IGT in pregnancy is predictive of poor pregnancy
outcomes.
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