RISKS OF ABNORMAL GLUCOSE TOLERANCE IN TEENAGE PREGNANCY

Abstract

Routine screening for gestational diabetes (GDM) is recommended for all pregnant women, but is unusual in clinics for adolescents. We performed a 50 g glucola loading test in 138 patients age 12-18 years at 24-34 weeks gestation. A 1h plasma glucose ≥ 150 mg/dl was an indication for a 3h OGTT. The study group was multiracial (38% Hispanic, 32% White, 22% Black and 8% other). Results: Mean 1h plasma glucose value for all patients was 103 mg/dl ± SD 22. 94 (68%) teenagers were ± 1SD of the mean while 21 (15%) were > 1SD below and 23 (17%) were > 1SD above the mean. GDM was confirmed in 2 girls (1.5%). Both gained excessive weight, had preeclampsia, large placentas and macrosomic infants. Girls with a 1h glucose > 1SD below the mean (< 82 mg/dl) had a lower Body Mass Index (BMI: Wt/Ht²; p <0.01) and more of their infants had fetal distress (p <0.01). BMI was not correlated with 1h glucose levels. Although 5 infants weighed > 4000 g, three had mothers with a 1h glucose 2SD below the mean while 2 others had levels > 2SD above the mean. Frequency distribution curves for 1h glucose values differed markedly in the four racial groups. The mostly Indochinese group had significantly lower 1h glucose levels than all other groups (p <0.008). Conclusions: All pregnant teenagers should be screened for GDM because this problem occurs in young as well as older women. Higher perinatal morbidity occurs in infants of mothers with low as well as high plasma glucose values.

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