The Effects of Hypoglycaemia and Hyperglycaemia on Pregnancy Outcome

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Abstract
Summary: A 50 g 3‐hour oral glucose tolerance test was performed on 5,000 consecutive patients during the third trimester of pregnancy. An increased incidence of complicated pregnancy outcome was seen when there was hypoglycaemia and hyperglycaemia (fifth and ninety‐fifth percentiles respectively for plasma glucose levels). Hypoglycaemia had a significant association with subnormal urinary oestriol excretion (P<0.05), fetal and placental growth retardation (P<0.001), and increased perinatal mortality (P<0.05). When there was hyperglycaemia, placental growth was stimulated (P<0.01) and perinatal mortality was increased (P<0.001). When urinary oestriol excretion was persistently subnormal and glucose tolerance was normal the perinatal mortality rate was 2.0%, whereas in the presence of hypoglycaemia this was 12.7% (P<0.001) and when there was hyperglycaemia the rate was 12.8% (P<0.001). Therapeutic measures applied to the patient who is hypoglycaemic, especially when there is subnormal oestriol excretion, require investigation and may enable reduction of perinatal mortality and morbidity.