COMPARISON OF WORLD-HEALTH-ORGANIZATION AND NATIONAL-DIABETES-DATA-GROUP PROCEDURES TO DETECT ABNORMALITIES AT GLUCOSE-TOLERANCE DURING PREGNANCY

OBJECTIVE - To compare the one-step procedure proposed by the World He alth Organization (WHO) with the two-step procedure proposed by the Na tional Diabetes Data Group (NDDG) for the identification of abnormalit ies of glucose tolerance during pregnancy. RESEARCH DESIGN AND METHODS - One hundred twenty-seven nondiabetic Pima Indian women had a 75-g 2 -h glucose tolerance lest (WHO criteria). Those with an elevated 1-h g lucose concentration (greater than or equal to 7.8 mmol/l) were referr ed for a 100-g 3-h glucose tolerance test (National Diabetes Data Grou p criteria). The effectiveness of the two test procedures was determin ed by comparing the frequency of macrosomia and cesarean section as ou tcomes of pregnancy. RESULTS - Of 42 women with 1-h plasma glucose con centrations greater than or equal to 7.8 mmol/l, 13 had no 100-g test, 27 had a normal test, and 2 had an abnormal test. Both women (100%) w ith abnormal two-step 100-g tests also had abnormal one-step 75-g test s, but only 2 of the 11 women (18%) with an abnormal one-step test had an abnormal two-step test. Sixteen of the 127 women delivered babies weighing greater than or equal to 4,000 g. Six of these women (38%) we re correctly identified as abnormal using the one-step test and one (6 %) using the two-step test. Of seven women delivering by cesarean sect ion, four (57%) had abnormal one-step tests, but none had an abnormal two-step test. CONCLUSIONS - The one-step WHO test for glucose toleran ce during pregnancy was abnormal in a greater percentage of women with adverse outcomes than the more cumbersome two-step NDDG test. The one -step test has the added advantage of being directly comparable to the standard glucose tolerance test used in nonpregnant women.