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Korean Journal of Obstetrics & Gynecology 1998;41(8):2126-2130.
Published online January 1, 2001.
The Significance of 50gm-Oral Glucose Tolerance Test in the Screening of Gestational Diabetes Mellitus.
M I Park, J J Kim, J H Lee, S R Kim, Y H Ahn
Abstract
One of the most common metabolic disorders that is complicated by pregnancy is gestational diabetes mellitus (GDM). GDM may be affiliated with various adverse outcomes of pregnancy including obstetrical complications such as increased rate of cesarean section, preeclampsia, and birth trauma, and perinatal morbidities, such as macrosomia, hypoglycemia, hypocalcemia, and hyperbilirubinemia. Women with GDM are at higher risk for non-insulin dependent diabetes mellitus later in life and are predisposed to dyslipidemia and cardiovascular disease. GDM may also have long-term affects on the offspring. The offspring of mothers with pregestational and gestational diabetes have been found with a higher frequency of obesity in childhood, impaired glucose tolerance or non-insulin dependent diabetes in adolescence or thereafter. The prevalence of GDM in Korean women is 2~3%, which is similar to that in Caucasian and African-American women in North America. The frequencies of obstetrical complications and adverse perinatal outcomes observed in Korean women with GDM are also similar to those in other reports. Thus, screening of GDM is very important in Korean women. This study was performed to assess the significance of 50 gm-oral glucose tolerance test (GTT) as a screening test of GDM from November, 1994 to September, 1996. The tests were performed during the 24~28th gestational weeks period. Three hundred twelve patients (235 high risk and 77 control) were entered to this study. The results were as follows. 1. The mean maternal age, gravity and parity in the high risk group were 30.93 6.82, 4.50 2.25, and 0.97 1.11, respectively. The mean maternal age, gravity and parity in the control group were 26.26 4.86, 1.95 1.31 and 0.35 0.72 respectively. No differences were presented between the two-groups. 2. The mean body mass index in the high risk group and control group was 21.23 2.64 and 20.10 2.68 kg/m2, respectively. No significant differences were noted between the two groups. The incidence of obesity in each group was 8.5% and 6.8%, respectively. 3. The mean birth weight of neonates in the high risk group and control group was 3075.0 582.7 gm and 3206.4 428.6 gm respectively. No differences were observed between the two groups. 4. The incidence (43%, 104/235) of positive screening tests (1hr oral GTT>130 gm/dl) in the high risk group was significantly higher than that (26%, 20/77) of the control group. 5. All positive results of 100gm-oral GTT (100%, 19/19) were seen from the patients with positive screening tests (50 gm-oral GTT). 6. All positive results of 100 gm-oral GTT were seen in patients whose levels above 140 mg/dL. No positive results were seen in patients whose levels between 130~139 mg/dL. In view of the above results, the authors believe that the screening test of GDM, 50 gm-oral GTT, would be preferable for `high risk groups of GDM` only, rather than for `all pregnant women`, at least in Korea.


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