Does raising the glucose challenge test threshold impact birthweight in Asian gravidas?

• Published in: Journal of perinatal medicine Vol. 35; no. 2; pp. 100 - 103
• Main Authors: Koklanaris, Nikki, Bonnano, Clarissa, Seubert, David, Anzai, Yuzuru, Jennings, Richard, Lee, Men-Jean
• Format: Journal Article
• Language: English
• Published: Berlin Walter de Gruyter 01.01.2007; New York, NY De Gruyter
• Subjects: Adult; Asian Continental Ancestry Group; Asian race; Biological and medical sciences; Birth Weight - physiology; Delivery. Postpartum. Lactation; Diabetes, Gestational - diagnosis; Diabetes, Gestational - ethnology; Diabetes, Gestational - physiopathology; ethnic variation; Female; gestational diabetes; glucose challenge test; Glucose Tolerance Test; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Pregnancy; Retrospective Studies; Ethnic origin; Asiatic; Asian race; Neonatology; Exploration; Glucose; Maternal diseases; Pregnancy; Race; glucose challenge test; Birth weight; Gestational diabetes; ethnic variation; Threshold
• ISSN: 0300-5577; 1619-3997
• DOI: 10.1515/JPM.2007.019

Objective: Some authors suggest a glucose challenge test (GCT) threshold of 150 mg/dL in Asian gravidas. The impact of such a policy on outcomes is unknown. Study Design: A retrospective cohort of 1705 Asian gravidas. Subjects (n=95) had a GCT of 140–150 mg/dL and underwent a 3-h glucose tolerance test (GTT). Matched controls (n=190) had a GCT of <140 mg/dL. Birthweight was the primary outcome and the secondary outcomes were cesarean delivery (CD) rate and macrosomia. Results: Eight subjects (11.9%) had gestational diabetes mellitus (GDM); none had GTT fasting values of >90 mg/dL. Mean birthweight was 3282 g in the subjects and 3238 g in the controls (P=0.39). There were no significant differences in the secondary outcomes. Conclusion: Compared with controls, study patients did not deliver significantly larger infants. However, raising the GCT threshold would have missed 8 subjects (11.9%) with GDM. Raising the GCT threshold to 150 mg/dL in Asian gravidas may unacceptably lower the sensitivity of the screening test.