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Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study.

ABSTRACT: OBJECTIVES:There is no consensus regarding a possible relation between false positive glucose challenge test (GCT) results and large-for-gestational-age (LGA) infants. This study aimed to clarify the association between false positive GCT results and LGA, after adjusting for potential confounding factors, using a large clinical dataset. DESIGN:Retrospective cohort study. SETTING:National Hospital Organisation Kofu National Hospital, which is a community hospital, between January 2012 and August 2019. PARTICIPANTS:Japanese women who underwent GCT between 24 and 28?weeks of gestation at the hospital were included. After excluding those with gestational diabetes mellitus, diabetes in pregnancy and multiple pregnancies, subjects were divided into a false positive GCT group (?140?mg/dL) and a GCT negative group (<140?mg/dL). METHODS:Obstetric records of patients were examined. The ?2-test and multivariable logistic regression analysis were used to investigate the association between false positive GCT results and LGA. PRIMARY AND SECONDARY OUTCOME MEASURES:Incidence of LGA and the association between false positive GCT results and LGA. RESULTS:The mean subject age was 31.4±5.5 years, with 43.3% nulliparity (n=974) and 2160 (96.1%) term deliveries. The incidence of LGA was 9.4% (211/2248) and 11.4% (257/2248) of the women had false positive GCT results. False positive GCT results were significantly associated with an increased risk of LGA (OR, 1.51; 95% CI, 1.02 to 2.23), after controlling for maternal age, prepregnancy maternal weight, maternal weight gain during pregnancy and parity. CONCLUSIONS:It appears that there is a significant association between false positive GCT results and LGA. Additional research is required to confirm these results and to investigate appropriate interventions for women with abnormal screens for gestational diabetes mellitus.

SUBMITTER: Shinohara S

PROVIDER: S-EPMC7045087 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study.

Shinohara Satoshi S Amemiya Atsuhito A Takizawa Motoi M

BMJ open 20200225 2

<h4>Objectives</h4>There is no consensus regarding a possible relation between false positive glucose challenge test (GCT) results and large-for-gestational-age (LGA) infants. This study aimed to clarify the association between false positive GCT results and LGA, after adjusting for potential confounding factors, using a large clinical dataset.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>National Hospital Organisation Kofu National Hospital, which is a community hospital, between Ja ...[more]

PMID: 32102822

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Project description:BackgroundBoth obesity and gestational diabetes (GDM) are associated with adverse outcomes. Diet during pregnancy impacts weight gain and fetal growth. Therefore, we aimed to explore non-pharmacological treatment success depending on pre-pregnancy body weight and its association with large for gestational age (LGA) infants in women with GDM.MethodsIn our observational study we investigated 57 singleton pregnant women with GDM. All women received standard treatment, including healthy diet education and regular medical checkups. Data were collected through blood analysis, medical records and questionnaires assessing diet before conception and during pregnancy. Differences in dietary patterns were compared in normal weight and overweight/obese group using Mann-Whitney U, Wilcoxon Signed Rank Test or Kruskal-Wallis test, as appropriate. Logistic regression was used for prediction of LGA. p-value less than 0.05 was used for statistical significance.ResultsPreconceptionally, the Mann-Whitney U test showed that the normal-weight group (n = 41) more frequently consumed fruits (U = 116.5, p < 0.001), eggs (U = 189.5, p = 0.02), cheese (U = 148.0, p = 0.003) compared to the overweight/obese group (n = 16), that consumed more beef (U = 407.0, p = 0.03) and low-calorie beverages (U = 397.0, p = 0.05). During pregnancy both groups improved their diet, with no differences detected. Personality types differed only preconceptionally with regard to healthy diet. Excessive gestational weight gain did not significantly differ between body-weight groups (16.6% vs. 23.1%), neither did the incidence of LGA infants (46.2% vs. 43.8%). Significant predictors of LGA were paternal height (OR = 1.12, 95% CI 1.01-1.23), 3rd trimester HbA1c (OR = 0.50, 95% CI 0.26-0.97), unemployment (OR = 4.80, 95% CI 1.12-20.61) and diet improvement during pregnancy (OR = 1.19, 95% CI 1.02-1.39). After adjustment improvement in diet was no longer a significant predictor for LGA.ConclusionEven though dietary patterns of the participants significantly improved during pregnancy, LGA infants were born independently of pre-pregnancy weight or diet and despite good glycemic control. Further research is needed to explore social determinants of health and whether solutions outside the health sector could provide efficient means in preventing adverse pregnancy outcomes as well as improving metabolic health.

Dataset Information

Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study.

Publications

Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study.

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