Clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies.

Autor: Fadiloglu E; Hacettepe University, Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey, Tel.: +90 5464750175., Tanacan A; Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey., Unal C; Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey., Aydin Hakli D; Department of Biostatistics, Hacettepe University, Ankara, Turkey., Beksac MS; Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Journal of perinatal medicine [J Perinat Med] 2019 Jul 26; Vol. 47 (5), pp. 534-538.
DOI: 10.1515/jpm-2018-0373
Abstrakt: Objective To demonstrate clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies. Methods We retrospectively evaluated 75-g GTT screening results of 356 pregnancies without prompt diagnosis of gestational diabetes mellitus (GDM) between January 2013 and December 2017. Newborns with a birthweight greater than the 90th percentile were evaluated as LGA. Pregnancies with LGA and non-LGA fetuses were compared by demographic and historical factors - maternal age, gravidity, parity, birthweight, birthweek, GTT results and birthweight percentiles - via Student's t-test. Multiple linear regression using the backward elimination method was performed to define the correlation between parameters and LGA (P-value of <0.20 was identified as the threshold). Receiver operator characteristics (ROC) curve analysis was performed for further analysis. Results The cohort was consisted of 45 (12.6%) and 311 (87.4%) pregnancies with LGA and non-LGA fetuses, respectively. Maternal age and 2nd-h GTT results were found to be significantly higher in patients with LGA newborns (P<0.001 and P=0.016, respectively). Fasting glucose levels and GTT 1st-h results were also higher (P=0.112, P=0.065). The coefficient of multiple determination (R2) was 0.055 by multiple linear regression analysis. Accordingly, GTT 2nd-h result and maternal age were statistically significant and contributed to the explanation of LGA, although the R2 value was not that much higher (P=0.016; P=0.001). Maternal age and GTT 2nd-h results were found to be associated with LGA fetuses with area under the curve (AUC) values of 0.662 and 0.608 according to ROC curve analysis. Conclusion Maternal age and 75-g GTT 2nd-h results were significantly higher in gestations with LGA newborns without GDM.
Databáze: MEDLINE