False-Positive 1-Hour Glucose Challenge Test and Adverse Perinatal Outcomes
- 1 January 2004
- journal article
- research article
- Published by Wolters Kluwer Health in Obstetrics & Gynecology
- Vol. 103 (1) , 148-156
- https://doi.org/10.1097/01.aog.0000109220.24211.bd
Abstract
To determine whether a false-positive 1-hour glucose challenge test (GCT) is associated with perinatal complications. We performed a retrospective cohort study of 1825 eligible pregnant women among a cohort of 1998 patients. Patients were screened for gestational diabetes mellitus (GDM) with the 1-hour 50-g GCT at 24-28 gestational weeks. A false-positive GCT was defined as a result greater than or equal to 135 mg/dL followed by a normal 3-hour glucose tolerance test (GTT). We compared the negative GCT and false-positive GCT cohorts for a composite perinatal outcome variable that included fetal macrosomia, antenatal death, shoulder dystocia, chorioamnionitis, preeclampsia, intensive care nursery admission, and postpartum endometritis. Secondary outcomes included cesarean delivery and each component variable of the composite. Unadjusted, stratified, and multiple logistic regression analyses were used to investigate the association between a false-positive GCT and the development of perinatal complications. We identified 164 patients with a false-positive GCT and 50 patients with GDM. The false-positive GCT cohort on average was older, of higher parity, had a higher body mass index, and more frequently had chronic hypertension, sickle cell trait, and elevated midtrimester human chorionic gonadotropin levels. The false-positive GCT cohort more frequently had adverse perinatal outcomes, including the composite perinatal outcome (odds ratio [OR] 5.96, 95% confidence interval[CI]1.47,24.16), macrosomia greater than 4500 g (OR 3.66, 95% CI 1.30, 10.32), antenatal death (OR 4.61, 95% CI 0.77, 27.48), shoulder dystocia (OR 2.85, 95% CI 1.25, 6.51), endometritis (OR 2.18, 95% CI 1.03, 4.63), and cesarean delivery (OR 1.76, 95% CI 0.99, 3.14). A false-positive GCT is an independent risk factor for adverse perinatal outcomes.Keywords
This publication has 21 references indexed in Scilit:
- Screening for gestational diabetes: a summary of the evidence for the U.S. Preventive Services Task ForceObstetrics & Gynecology, 2003
- EARLY GLYCEMIC CONTROL REDUCES LARGE-FOR-GESTATIONAL-AGE INFANTS IN 250 JAPANESE GESTATIONAL DIABETES PREGNANCIESAmerican Journal of Perinatology, 2000
- Postpartum oral glucose tolerance tests in mothers of macrosomic infants: inadequacy of current antenatal test criteria in detecting prediabetic stateEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 1999
- Gestational diabetes mellitus and glucose intolerance in a Mexican populationInternational Journal of Gynecology & Obstetrics, 1997
- Relationship between plasma glucose levels in glucose-intolerant women and newborn macrosomiaThe Journal of Maternal-Fetal Medicine, 1997
- Comparison of National Diabetes Data Group and World Health Organization criteria for detecting gestational diabetes mellitusDiabetologia, 1996
- Impaired Glucose Tolerance in Pregnancy - Is It of Consequence?Australian and New Zealand Journal of Obstetrics and Gynaecology, 1996
- Can a diagnosis of gestational diabetes be an advantage to the outcome of pregnancy?Journal of the Society for Gynecologic Investigation, 1995
- Difference in prevalence of gestational diabetes and perinatal outcome in an innercity multiethnic London populationEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 1995
- Poor sensitivity of the fifty-gram one-hour glucose screening test for hyperglycemiaEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 1994