Effect of Initial Glucose Tolerance Test Response on Pregnancy Outcomes in Type A1 Gestational Diabetes

BACKGROUND This retrospective study of obstetric data from 281 cases of type A1 gestational diabetes mellitus (GDM) aimed to evaluate the association between the response to a first oral 75 g glucose tolerance test and adverse pregnancy outcomes. MATERIAL AND METHODS A total of 281 pregnant women with type A1 GDM and 151 pregnant women without GDM were analyzed for clinical test indicators and pregnancy outcomes. We compared categorical variables using chi-square test, and analyzed computational variables using the independent sample t test and one-way ANOVA. RESULTS Compared with the normal group, the GDM group showed an increase in serum ferritin (P<0.001), uric acid (P=0.02), creatinine (P=0.02), C-reactive protein (P<0.001), and neutrophils (P=0.03). Risk of premature rupture of membranes and preterm birth also increased. In GDM group, isolated fasting hyperglycemia group (IFH) had the highest proportion of patients with prehypertension (P<0.001), creatinine (P=0.01) increased the most among the 3 groups, and incidence of fetal macrosomia was highest (P=0.01). The isolated post-load hyperglycemia group (IPH) had the highest proportion of patients whose umbilical artery resistance index (RI; P<0.001) exceeded normal range during delivery. CONCLUSIONS IFH group had the highest blood pressure, premature rupture of membranes, and incidence of fetal macrosomia. We recommended actively monitoring blood pressure, controlling diet and weight, and avoiding the above complications. Pregnant women with IPH have the highest proportion of umbilical artery RI exceeding the normal range during delivery, and the highest number of cases of fetal growth restriction. Therefore, close monitoring of fetal growth and development should be conducted.