Evaluation of the results of 50 gr OGTT for detection of gestational diabetes in pregnant women in Ankara Atatürk Training and Research Hospital Obstetrics Polyclinic

Objectives: Hormonal changes during pregnancy increases the risk of insulin resistance. When the compensation mechanisms prove to be inadequate, maternal gestational diabetes is inevitable. Gestational diabetes brings too many risks for both the mother and the baby, during pregnancy, delivery and the rest of their lives. Accordingly, it is very critical to screen for gestational diabetes and to take timely precautions. GDM being a preventable disorder when diagnosed early, the main purpose of our study is to determine the incidence rate of gestational diabetes mellitus, to evaluate the results of GDM screening tests and to analyzd the relationship between oral glucose tolerance test disorder and age, parity and body mass index (BMI). Material and Methods: Our study includes 332 patients who were admitted to Ankara Atatürk Training and Research Hospital Obstetrics Polyclinic between July 1st 2014 and October 28th, 2014 and were administered 50 gr of OGTT. Patients' records were retrospectively reviewed from the computer system of our hospital and demographics, OGTT results, pregnancy history were recorded. The resulting data were analyzed using SPSS for Windows, version 20. χ2, Kolmogorov-Smirnov/Shapiro-Wilk, Student's t, One-Way Anova, Mann-Withney U, Kruskal-Wallis, Pearson Correlation Coefficient and Spearman Correlation Coefficient tests were all used for evaluating the results. Statistical significance level was taken as p<0,05. This study was preapproved with decision number 86 during the March 11th, 2015 meeting of the Clinical Research Ethics Committee of Yıldırım Beyazıt University, Faculty of Medicine. Results: The frequency of GDM was recorded as 5,4% and that of IGT as 4,2%. The average age of our patients was 27,6±5,2 years. When the relationship between the age groups with the disorder of screening test examined; 50 gr OGTT failure was significantly higher in the patient group older than 30 years compared to the age group under 25 years (p=0,001). BMI average of the study population was 27.1 ± 4.5 and there is no statistically significant difference between the diagnosis groups in terms of BMI. Also, we couldn't find statistically significant difference between the diagnosis groups in terms of mothers' pregnancy stories. The average infant birth weight was 3322.5±479.5 grams. Macrosomia was detected in 6.9% of the infants. None of the mothers of macrosomic infants was diagnosed with GDM. There was no statistically significant difference between the diagnosis groups in terms of infant birth weight(p=0,15), infant gender (p=0,76) or mode of delivery (p=0,51). Conclusion: A risk assessment associated with GDM on which too many detrimental effects are tagged, should be carried out during the first visit of a pregnant woman and based on the current risk situation, labwork and follow-up processes should immediately be initiated. Due to the simplicity and straight-forward nature of the 50 gr OGTT, it must be administered at primary care units and pregnant women should not be directed to a hospital only for this test. Advice over proper nutrition, exercise and weight control should be given to the pregnant and a specialist's opinion should be sought when needed. When the statistical distribution of the mother's blood type and the infant's gender on diagnosis groups was evaluated; statistically insignificant quantitative differences were noticed. As a conclusion, more studies involving larger test populations are needed in order to develop intuition about these factors. Keywords: Gestational diabetes mellitus, 50 g OGTT, management