AIMS This study aimed to investigate whether pregnancies complicated by gestational diabetes mellitus (GDM) present differences in the outcomes according to the findings on oral glucose tolerance test (OGTT), including fasting, post-load or combined abnormal blood glucose. MATERIALS This was a prospective cohort study including 831 singleton pregnancies with GDM per the IADPSG criteria. According to their fasting blood glucose value on OGTT the women were categorized in three groups: (i) GDM women with fasting plasma glucose levels > 92 mg/dl and normal post-load values (T0 abnormal group), (ii) patients with abnormal values at 60' and/or 120' and normal fasting values (T-post group) and (iii) patients with combined fasting and post-load abnormal blood glucose values (T-comb). Regression analysis was used to test the independent contribution of the different groups, along with maternal and fetal characteristics, in prediction of (i) large for gestational age (LGA), (ii) need for insulin treatment and (iii) birthweight centile. RESULTS GDM with abnormal fasting blood glucose was an independent risk factor for LGA (OR 2.91, 95% CI 1.33-6.36) and was associated with higher birthweight centile (10.25, 95% CI 0.27-20.25). GDM with combined fasting and post-load abnormal blood glucose was an independent risk factor for insulin treatment (OR 2.94, 95% CI 1.93-4.47). CONCLUSIONS Women with GDM and abnormal fasting blood glucose are at increased risk for large for gestational age neonates, while women with GDM and combined fasting and post-load abnormal blood glucose are at increased risk for insulin therapy.

中文翻译：

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妊娠糖尿病妇女的口服葡萄糖耐量试验的空腹，后负荷或合并血糖值异常和妊娠结局。

目的本研究旨在根据口服葡萄糖耐量试验（OGTT）的结果，包括空腹，负荷后或合并异常血糖，调查妊娠合并妊娠糖尿病（GDM）的妊娠结局是否存在差异。材料这是一项前瞻性队列研究，包括根据IADPSG标准进行的831例单胎妊娠GDM。根据她们在OGTT上的空腹血糖值，将妇女分为三组：（i）空腹血糖水平> 92 mg / dl且负荷后值正常的GDM妇女（T0异常组），（ii）异常的患者60'和/或120'时的血糖值和正常的空腹值（T-post组），以及（iii）合并空腹和负荷后异常血糖值（T-comb）的患者。回归分析用于检验不同组别以及母亲和胎儿特征的独立贡献，以预测（i）胎龄（LGA）大，（ii）需要胰岛素治疗和（iii）出生体重百分位数。结果空腹血糖异常的GDM是LGA的独立危险因素（OR 2.91，95％CI 1.33-6.36），并与较高的出生体重百分数（10.25，95％CI 0.27-20.25）相关。合并禁食和负荷后异常血糖的GDM是胰岛素治疗的独立危险因素（OR 2.94，95％CI 1.93-4.47）。结论患有GDM和空腹血糖异常的妇女妊娠大龄婴儿的风险较高，而患有GDM且空腹血糖和负荷后血糖异常的孕妇胰岛素治疗的风险较高。