CAN 50 G ORAL GLUCOSE CHALLENGE TEST PREDICT INTRAUTERINE GROWTH RETARDATION?

Öz

Aim: To investigate a likely association between intrauterine growth IUGR retardation and maternal plasma glucose level after 50 g glucose challenge test GCT . Materials and Method: Forty-two pregnant women with IUGR IUGR group and eighty pregnant women with appropriate for gestational age control group enrolled into the study. The results of GCT which performed between 24 to 28 weeks of pregnancy, umbilical arterial Doppler flow velocimetry, birth weights, gestational ages at the time of delivery, and 5th minute APGAR scores were compared between the groups.Statistical analyses were carried out by using the statistical packages for SPSS 15.0 for Windows. Results: Maternal characteristics;average ages, body mass index BMI and gravidity were similar in both two groups. There were statistically significantly lower maternal 1-hour plasma glucose levels and birth weights in IUGR group than control group. The differences of umbilical arterial Doppler flow velocimetry, gestational ages at the time of delivery, 5th minute APGAR scores and admission to the neonatal intensive care unit NICU between the groups were statistically significant. Conclusion: Low 1-hour glucose response to the 50 g glucose challenge is associated with IUGR.

Anahtar Kelimeler

• hypoglycemia,50 g glucose challenge test,intrauterine growth retardation,pregnancy

50 GRAM ORAL GLUKOZ TESTİ İLE İNTRAUTERİN GELİŞME KISITLILIĞI TAHMİN EDİLEBİLİR Mİ?

Öz

Amaç: Intrauterin gelişme geriliği IUGR ile 50 gram oral glukoz testi arasındaki olası ilişkinin araştırılması. Gereçler ve Yöntem: Gebeliği IUGR ile komplike olan 42 kadın IUGR grup ile gebeliğinde gelişme gerililiği olmayan 80 kadın kontrol grup çalışmaya dâhil edildi. 24-28 hafta arası yapılan 50 g oral glukoz testinin sonucu, umbilikal arter Dopler akım değerleri, doğum sırasındaki gebelik haftası ve 5. Dakika APGAR skoru her iki grupta karşılaştırıldı. İstatistiksel analizler SPSS 15 programı kullanılarak yapıldı. Bulgular: Ortalama yaş, vücut kitle indeksi VKI ve gravidite gibi maternal özellikler her iki grupta da benzerdi. 1. Saat maternal serum glukoz seviyesi, IUGR grubunda kontrol grubuna göre istatistiksel olarak anlamlı daha düşük bulundu p=0.012 . Her iki grup için umbilikal arter dopler akımları, doğum sırasındaki gebelik haftası, 5. Dakika APGAR skoru ve yeni doğan yakın bakım ünitesine başvuru oranları arasında istatistiksel olarak anlamlı bir farklılık vardı p

Anahtar Kelimeler

• Hipoglisemi,50 gram glukoz testi,intrauterine gelişme gerililiği,gebelik

Kaynakça

1. 1. Kjos SL, Buchanan TA. Gestational diabetes mellitus. N Engl J Med 1999;341(23):1749-56.
2. 2. Langer O, Levy J, Brustman L, Anyaegbunam A, Merkatz R, Divon M. Glycemic control in gestational diabetes mellitus--how tight is tight enough: small for gestational age versus large for gestational age? Am J Obstet Gynecol 1989;161(3):646-53.
3. 3. Casey BM, Lucas MJ, McIntire DD, Leveno KJ. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol 1997;90(6):869-73.
4. 4. Abell DA. The significance of abnormal glucose tolerance (hyperglycaemia and hypoglycaemia) in pregnancy.Br J Obstet Gynaecol 1979;86(3):214-21.
5. 5. Sokol RJ, Kazzi GM, Kalhan SC, Pillay SK. Identifying the pregnancy at risk for intrauterine growth retardation: possible usefulness of the intravenous glucose tolerance test. Am J Obstet Gynecol 1982;143(2):220-3.
6. 6. Piper JM, Field NT, Higby K, Elliott BD, Langer O. Maternal-fetal glucose metabolism and fetal growth retardation. Is there an association? J Reprod Med 1996;41(10):761-6
7. 7. Langer O, Damus K, Maiman M, Divon M, Levy J, Bauman W. A link between relative hypoglycemiahypoinsulinemia during oral glucose tolerance tests and intrauterine growth retardation. Am J Obstet Gynaecol 1986: 155 (4):711-6.
8. 8. Greeff MC, Rothberg AD, Brauteseth RM, Rabinowitz L. Prediction of intra-uterine growth retardation using maternal glucose tolerance and anthropometric data. SAMJ 1987;72(9):612-5.

9. 9. Calfee EF, Rust OA, Bofill JA, Ross EL, Morrison JC. Maternal hypoglycemia: is it associated with adverse perinatal outcome? J Perinatal 1999;19(5):379-82.
10. 10. Khouzami VA, Ginsburg DS, Daikoku NH, Johnson JW. The glucose tolerance test as a means of identifying intrauterine growth retardation. Am J Obstet Gynecol 1981;139(4):423-6.
11. 11. Committee on Practice Bulletins--Gynecology ACoO, Gynecologists WDCUSA. Intrauterine growth restriction. Clinical management guidelines for obstetrician-gynecologists. American College of Obstetricians and Gynecologists. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2001;72(1):85-96.
12. 12. Feinberg JH, Magann EF, Morrison JC, Holman JR, Polizzotto MJ. Does maternal hypoglycemia during screening glucose assessment identify a pregnancy at-risk for adverse perinatal outcome? J Perinatal 2005;25(8):509-13.
13. 13. Pugh SK, Doherty DA, Magann EF, Chauhan SP, Hill JB, Morrison JC. Does hypoglycemia following a glucose challenge test identify a high risk pregnancy? J Reprod Health 2009;6:10.