Postpartum and perinatal outcomes of pregnants with abnormal 50 g glucose challenge test followed by a normal 100 g oral glucose tolerance test

Background: Gestational diabetes mellitus (GDM) is defined as any degree of carbohydrate intolerance with onset or first recognition during pregnancy. 2-3% of all pregnancies are complicated by diabetes. Although the risks associated with GDM are well recognised, the impact on maternal and infant health outcomes is less clear for borderline gestational diabetes mellitus (BGDM) which is characterised by values of glucose tolerance intermediate between normal and gestational diabetes. In our study , we aimed to investigate postpartum and perinatal outcomes of pregnants with abnormal 50 g glucose challenge test (GCT) followed by a normal 100 g oral glucose tolerance test (OGTT).Study Design: The study group was created with 70 pregnant women who have abnormal 50 g GCT followed by a normal 100 g OGTT. The control group was created with 122 pregnant women who have normal 50 g GCT. Multiple gestations, anomalous fetuses and patients with pregestational diabetes were excluded from the study. The cutoff value for 50 g GCT was taken ?140 mg/dl and Carpenter and Coustan criterias were used for 100 g OGTT. Pregnant women were followed until delivery, postpartum and perinatal outcomes were compared.Results: Maternal age, gravidity, parity, prepregnancy and postpregnancy body mass index, gestational weight gain, family history of diabetes, diabetes in previos pregnancy were higher in study group (p<0.05). Polyhydramnios, macrosomia and mean birthweight were significantly higher in study group (p<0.05).Conclusion: Some characteristics of borderline diabetics are similar with gestational diabetic patients. Advanced maternal age, higher prepregnancy body mass index, parity, family history of diabetes, macrosomic babies, polyhydramnios are seen more often in diabetic pregnants. In study group, these charecteristics of patients are similar to diabetic pregnants. The pregnants with positive GCT but negative for OGTT might be managed as diabetic ones with diet control, exercise, close monitorization of weight gain and more often fetal monitorization. However, maybe a group of women who have an increased likelihood of the development of overt diabetes mellitus later in life. Therefore, these women should be counseled to keep an appropriate life style and to be screened periodically for diabetes mellitus after pregnancy. Searching the literature there are some studies of these major patient group and it seems that we need further studies about clinical outcomes of pregnants with positive GCT but negative for OGTT.