Association of hypoglycaemia in screening oral glucose tolerance test in pregnancy with low birth weight fetus

作     者：Ananth U Nayak Arun M A Vijay Radha Indusekhar Sushuma Kalidindi Venkata M Katreddy Lakshminarayanan Varadhan 

作者机构：Combined Antenatal Diabetes Clinic University Hospital of North Midlands NHS Trust 

出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)

年 卷 期：2019年第10卷第5期

页      面：304-310页

核心收录：

学科分类：10[医学] 

主　　题：Hypoglycemia Glucose tolerance test Low birth weight Pregnancy 

摘      要：BACKGROUND Gestational diabetes mellitus(GDM) is a common metabolic derangement in pregnant women. In the women identified to be at high risk of GDM, a 75 g oral glucose tolerance test(OGTT) at 24-28 wk gestation is the recommended screening test in the United Kingdom as per National Institute for Health and Care Excellence(NICE). Hypoglycaemia following the glucose load is often encountered and the implication of this finding for the pregnancy, fetus and clinical care is *** To determine the prevalence of hypoglycaemia at any time during the screening OGTT and explore its association with birth *** All deliveries between 2009 and 2013 at the local maternity unit of the University hospital were reviewed. Of the total number of 24,154 women without preexisting diabetes, those who had an OGTT for GDM screening based on NICE recommended risk stratification, who had a singleton delivery and had complete clinical and demographic data for analysis, were included for this study(n =3537). Blood samples for fasting plasma glucose(FPG), 2-hour plasma glucose(2-h PG) and HbA1 c had been obtained. Birth weight was categorised as low(≤ 2500 g), normal or Macrosomia(≥ 4500 g) and blood glucose ≤ 3.5 mmol/L was used to define hypoglycaemia. Binary logistic regression was used to determine the association of various independent factors with dichotomized variables; the differences between frequencies/proportions by χ~2 test and comparison between group means was by one-way *** Amongst the study cohort(3537 deliveries), 96(2.7%) women had babies with LBW( 2500 g). Women who delivered a LBW baby had significantly lower FPG(4.3 ± 0.6 mmol/L, P = 0.001). The proportion of women who had a 2-h PG ≤ 3.5 mmol/L in the LBW cohort was significantly higher compared to the cohorts with normal and macrosomic babies(8.3% vs 2.8% vs 4.2%; P = 0.007). The factors which predicted LBW were FPG, Asian ethnicity and 2-h PG ≤ 3.5 mmol/L,whereas maternal age, 2-h PG ≥ 7.8 mm