Perinatal Outcomes in Pregnant Women with Impaired Glucose Tolerance (IGT) Proven through 100 g Oral Glucose Tolerance Test (OGTT)

Yi, Kyong Wook; Jung, Jae Won; Shin, Jung Ho; Oh, Min Jeong; Lee, Jae Kwan; Hur, Jun Young; Saw, Ho Suk; Park, Yong Kyun

Abstract

OBJECTIVE: To compare the perinatal outcomes of pregnant women with 100 g oral glucose tolerance test (OGTT) proven impaired glucose tolerance (IGT), with normal control and gestational diabetes mellitus (GDM) groups. METHODS: 159 pregnant women who had visited our medical center between March 2002 and March 2004, positive (> or = 140 g) for 50 g OGTT were included in this study. IGT was defined by the presence of one abnormal 100 g OGTT glucose value, and they were compared with the control group, and the GDM group(with at least 2 abnormal glucose values). The maternal and neonatal outcomes were assessed among three groups. RESULTS: Even though familial history of DM was significantly higher in the IGT and GDM group (p<0.001) compared with the control group, no difference was observed in the frequency of previous GDM. The rate of fetal macrosomi a (>4 kg) and hypoglycemia was significantly increased in GDM group than other groups. The difference in the frequency of i) large for gestational age birthweight (>90 percentile) ii) preterm delivery, iii) APGAR score (1-min and 5-min), iv) shoulder dystocia, and v) congenital anomalies among the three groups was not notable-however, the incidence of neonatal hyperbilirubinemia was significantly higher and duration of NICU admission is significantly longer in the IGT group, compared to the control group (p<0.001). In maternal outcomes, whereas no significant difference was observed concerning the frequency of i) polyhydramnios (>95%) ii) infections (genitourinary and surgical wounds) in the three groups, the prevalence of preeclampsia was significantly higher in the IGT (p=0.018) and GDM group (p=0.023), compared with the control group. CONCLUSION: Neonatal hyperbilirubinemia, as well as maternal preeclampsia were significantly elevated in the IGT group. The results obtained thus far demonstrate the possibility of the need for active perinatal care with therapeutic intervention in pregnant women with IGT.