Evaluating the effect of gestational diabetes mellitus on macrosomia based on the characteristics of oral glucose tolerance test.

GDM is always treated as a homogenous disease ignoring the different metabolic characteristics in oral glucose tolerance test (OGTT). We assessed the effect of GDM on macrosomia based on the different characteristics of OGTT. We retrospectively divided 998 GDM pregnant women into 7 groups, Group A1: abnormal OGTT0h; Group A2: abnormal OGTT1h; Group A3: abnormal OGTT2h; Group B1: abnormal OGTT0h+1h; Group B2: abnormal OGTT0h+2h; Group B3: abnormal OGTT1h+2h; Group C: abnormal OGTT0h+1h+2h. The incidence of macrosomia in group C (21.92%) was higher than other groups. The OR of OGTT0h+1h+2h was significant (OGTT1h: OR = 1.577, 95% CI: 0.791, 3.145; OGTT2h: OR = 1.151, 95% CI: 0.572, 2.313; OGTT0h+1h: OR = 1.346, 95% CI: 0.584, 3.101; OGTT0h+2h: OR = 1.327, 95% CI: 0.517, 3.409; OGTT1h+2h: OR = 0.771, 95% CI: 0.256, 2.322; OGTT0h+1h+2h: OR = 4.164, 95% CI: 2.095, 8.278) when comparing with OGTT0h. Subgroup analysis showed abnormal OGTT0h+1h+2h might contribute more to macrosomia in pre-pregnancy BMI ≥ 24 kg/m2 than those with BMI < 24 kg/m2. The effect of abnormal OGTT0h+1h+2h on macrosomia was significantly greater than other OGTT characteristics, especially for those with pre-pregnancy BMI ≥ 24 kg/m2. Individualized management of GDM based on OGTT characteristics and pre-pregnancy BMI might be needed. Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Citation

Wenlin Bai, Hui Wang, Ruiling Fang, Mengwen Lin, Yao Qin, Hongjuan Han, Jing Cui, Rong Zhang, Yifei Ma, Durong Chen, Wenping Zhang, Li Wang, Hongmei Yu. Evaluating the effect of gestational diabetes mellitus on macrosomia based on the characteristics of oral glucose tolerance test. Clinica chimica acta; international journal of clinical chemistry. 2023 Apr 01;544:117362

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PMID: 37088117

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