(461) Does the number of abnormal values in the oral glucose tolerance test impact pregnancy outcomes?

The objective of this study was to assess the association between the number of abnormal values (AVs) in oral glucose tolerance test (OGTT) and adverse maternal and neonatal outcomes, among women diagnosed with gestational diabetes mellitus (GDM), considering its impact on the course of pregnancy, delivery, maternal health, and neonatal outcomes.

Study Design:

This retrospective cohort study included all pregnant women who underwent OGTT between the years 2015 and 2022, and diagnosed with GDM, at our department. The study cohort was divided into four groups based on the number of AVs in the OGTT: one AV, two AVs, three AVs and four AVs group. Maternal characteristics and pregnancy outcomes were compared between these groups.

Results: A total of 1893 women diagnosed with GDM, through OGTT were included in the study. Among them 781 had one AV, 787 had two AVs, 267 had three AVs and 58 had four AVs. The rate of GDMA2 was higher among women with higher AVs in OGTT: 28.4% vs. 25.5% vs. 38.6%, vs. 65.5% among the one AV, two AVs, three AVs and four AVs groups, respectively (p< 0.001).  The higher AVs groups were associated with increased maternal BMI (p=0.004), gravidity (p=0.002), and parity (p=0.001). Additionally, there was an increased rate of labor induction (p=0.002), episiotomy (p< 0.001), neonatal Apgar score < 7 (p=0.006), and NICU admission (p=0.008) in the higher AVs groups. There were no between groups differences in mode of labor, rate of macrosomia, shoulder dystocia, and composite adverse neonatal outcomes. 

Conclusion:

The study findings suggest that a higher the number of AVs in OGTT, indicates difficulty in regulating blood sugar with diet alone, which may require medical treatment and intervention. The OGTT not only aids in diagnosing GDM but also allows clinicians to be more aware about potential adverse maternal and neonatal outcomes by closely examining the number of abnormal values.