Relationship between Positive Glucose Screening, Obesity and Pregnancy Outcome in the Absence of Gestational Diabetes: A Retrospective Cohort StudyReportar como inadecuado




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Background: Currently pregnant womenwith abnormal glucose screening test GCT, performed at 26 - 28weeks gestation with a subsequent normal glucose tolerance test GTT receiveroutine care. Could these women be at risk of adverse pregnancy? Objective:Compare rate of caesarean section CS, induction of labour IOL, macrosomia,admission to special care nursery and neonatal hypoglycaemia. Designs:Retrospective cohort study. Setting: Ipswich Hospital, Ipswich, Queensland.Participants: Pregnant women having had the test at the hospital laboratory.Methods: Charts review of outcome measures including induction of labour,caesarean section, macrosomia, RDS and short-term neonatal morbidity. Results:We reviewed 882 charts 441 cases and 441 controls. There was a higher IOLrate among cases 21.1% versus 16.6% OR and 95% CI 1.45; 1.03 - 2.06and a higher CS rate, 30.4 versus 23.6 OR and 95% CI 1.41; 1.05 - 1.91.Compared to women with BMI 18.5 - 24.9, women with BMI of 30 and above had asignificantly higher IOL rate 47.1% versus 22.6%, higher CS rate 47.2%versus 25.7% and higher rate of macrosomic baby 79.2% versus 4.2%. Therewere more women amongst the cases who were older, smoked, had a BMI 30 andabove and had previous history of GDM. After adjusting for maternal age, BMIand smoking status, there was still an increased odds of CS, IOL andmacrosomia, but this did not reach statistical significance. Conclusion:Abnormal glucose screening test in the absence of gestational diabetes isassociated with adverse pregnancy outcome. This is largely contributed bymaternal obesity.

KEYWORDS

Positive Glucose Screening Test, Gestational Diabetes, Obesity and Pregnancy Outcome

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Mahomed, K. , Young, S. , Ibiebele, I. and Hoare, J. 2014 Relationship between Positive Glucose Screening, Obesity and Pregnancy Outcome in the Absence of Gestational Diabetes: A Retrospective Cohort Study. Open Journal of Obstetrics and Gynecology, 4, 524-530. doi: 10.4236-ojog.2014.49074.





Autor: Kassam Mahomed, Sharleen Young, Ibinebo Ibiebele, Jane V. Hoare

Fuente: http://www.scirp.org/



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