Evidence map›Paper›PMID 39473341›Full record

ArticleActa obstetricia et gynecologica Scandinavica2025

Perinatal and neonatal outcomes in gestational diabetes: The importance of the number of abnormal values in an oral glucose tolerance test.

Sanna Eteläinen, Elina Keikkala, Shilpa Lingaiah, Matti Viljakainen, Tuija Männistö, Anneli Pouta, Risto Kaaja, Johan G Eriksson, Hannele Laivuori, Mika Gissler and 2 more

Abstract read
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Article in Acta obstetricia et gynecologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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0cells of the map it votes in
5citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sanna EteläinenResearch Unit of Clinical Medicine, Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Elina KeikkalaResearch Unit of Clinical Medicine, Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Shilpa LingaiahResearch Unit of Clinical Medicine, Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.ORCID 0000-0003-0005-9187
Matti ViljakainenResearch Unit of Clinical Medicine, Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Tuija MännistöNorthern Finland Laboratory Centre (NordLab), Department of Clinical Chemistry, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Anneli PoutaResearch Unit of Clinical Medicine, Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Risto KaajaDepartment of Internal Medicine, Institute of Clinical Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Johan G ErikssonDepartment of General Practice and Primary Health Care, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Hannele LaivuoriDepartment of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.ORCID 0000-0003-3212-7826
Mika GisslerDepartment of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland.
Eero KajantieResearch Unit of Clinical Medicine, Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Marja VääräsmäkiResearch Unit of Clinical Medicine, Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionGestational diabetes mellitus (GDM) is defined by one or more abnormal values in an oral glucose tolerance test (OGTT). The significance/importance of the number of abnormal values in relation to adverse perinatal and neonatal outcomes is unclear. We assessed the association of these outcomes with the number of abnormal glucose values in a 2-h 75 g OGTT in a large register-based cohort. MATERIAL AND

methodsThis sub-study of the Finnish Gestational Diabetes Study was based on the Finnish Medical Birth Register 2009 supplemented with OGTT laboratory data of 4869 pregnant women from six Finnish hospitals. The diagnostic cut-offs in OGTT according to the Finnish guidelines for plasma samples were ≥5.3 mmol/L (fasting), ≥10.0 mmol/L 1 h or ≥8.6 mmol/L 2 h after the glucose load. As per the guidelines, women with one or several abnormal OGTT values received diet and lifestyle counseling in the primary care, self-monitored their glucose values and received pharmacological therapy as needed. Women with GDM were categorized according to the number of abnormal glucose values. The primary outcomes, composites of adverse perinatal (pre-eclampsia, preterm delivery, macrosomia or primary cesarean section) and neonatal outcomes (birth trauma, neonatal hypoglycemia, hyperbilirubinemia or stillbirth/perinatal mortality), were analyzed by logistic regression adjusted for maternal age, pre-pregnancy body mass index, parity, socio-economic status and smoking.

resultsOf all the women, 877 (18.0%) had one, 278 (5.7%) two and 79 (1.6%) three abnormal OGTT values, while 3635 (74.7%) women were normoglycemic. Women with at least two abnormal OGTT values had higher proportions of adverse perinatal composite (35.0% vs. 27.5%, adjusted odds ratio 1.36; 95% confidence interval 1.03-1.81) and neonatal composite outcomes (31.1% vs. 18.9%, adjusted odds ratio 1.88; 95% confidence interval 1.40-2.52) compared to women with one abnormal value. The risks of delivery induction and neonatal hypoglycemia were increased regardless of the number of abnormal values when compared with normoglycemic women.

conclusionsThe risk of adverse perinatal and neonatal outcomes is significantly higher in women with two or more abnormal OGTT values than in those with one abnormal value.

Indexed as

Diabetes, GestationalGlucose Tolerance TestPregnancy OutcomeAdultBlood GlucoseFemaleFetal MacrosomiaFinlandHumansInfant, NewbornPregnancyPremature BirthRegistriesBlood Glucosecomposite outcomesgestational diabetesneonatal outcomesoral glucose tolerance testperinatal outcomes

Identifiers

PMID39473341
PMCPMC11683557

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.