Screening for gestational diabetes mellitus in adolescent pregnancies

Objective: Our purpose was to determine the incidence of gestational diabetes mellitus in an adolescent population and to determine the cost of screening. Study Design: A retrospective review of 509 adolescent pregnancies was performed. The incidence of gestational diabetes mellitus was determined and the cost of screening analyzed. Results: Five hundred nine adolescent pregnancies were screened for gestational diabetes mellitus with a 1-hour, 50 gm oral glucose challenge test. Twenty-three of the screens (4.5%) had positive results at a plasma glucose level of ≥140 mg/dl. Three-hour 100 gm oral glucose tolerance tests were performed on screen-positive women, six of whom were diagnosed with gestational diabetes mellitus, for an incidence of 1.18%. The cost per case diagnosed was $2733. Conclusions: The incidence of gestational diabetes mellitus in an adolescent population is low. The cost of universal screening may be prohibitive in this population. Large prospective studies are needed to better analyze outcome data and efficacy of screening in adolescent pregnancies. (Am J Obstet Gynecol 1998;178:1251-6.)     

Screening for gestational diabetes mellitus in adolescent Hispanics

Objective: To determine the incidence of gestational diabetes mellitus in an adolescent Hispanic population and calculate the cost of screening.Methods: A retrospective chart review of deliveries to adolescent (<20 years old) Hispanic women from January 1991 through May 1996 was performed. The incidence of gestational diabetes mellitus (GDM) was determined and the cost of screening calculated.Results: Three hundred twenty-six adolescent Hispanic women were screened for GDM with a 1-hour 50-g oral glucose tolerance test at an average gestational age of 26 weeks (range 11–39 weeks), at a cost of $26 per test. Thirty (9.2%) had positive screens defined as a plasma glucose level of ≥140 mg%. Three-hour 100-g oral glucose tolerance tests were performed on those with positive screens, at a cost of $124 per test. Five women were diagnosed with GDM, an incidence of 1.5%. The cost to diagnose each case of GDM was $2,569.Conclusion: The incidence of GDM in this population is low, and therefore universal screening of Hispanic adolescents may be unwarranted and cost prohibitive. Large prospective trials evaluating maternal and neonatal outcomes would provide the best means to assess the value of screening.     

Studies on glucose challenge test (GCT) as a screening procedure for gestational diabetes mellitus

A glucose challenge test (GCT) was developed as a screening procedure for the diagnosis of gestational diabetes mellitus (GDM). The method includes a 50gm oral glucose load and measurement of the plasma glucose concentration once at one hour after ingestion. The data were examined in 1,184 pregnant women seen at the outpatient clinic of our department from May 1984 to December 1986. Prior to the present study, 722 pregnant women were given a 75gm glucose tolerance test (75gGTT) and plasma glucose and IRI values were also analyzed. 1) Because glucose tolerance evaluated by the GCT was revealed to be impaired around the 28th week of pregnancy, it seems appropriate that screening for GDM should be planned during this period whenever possible. 2) The mean values obtained with GCTs performed before and after 28 weeks were 119 +/- 25mg/dl and 128 +/- 25mg/dl, respectively. 3) When the one-hour plasma glucose levels were compared after one 50 and one 75gm glucose load at intervals of less than 2 weeks, there was reproducibility in individual women with normal glucose tolerance, while the results were consistent in patients with DM or GDM. A mean difference of 18mg/dl at one hour was shown between the different glucose loads. 4) When screening for GDM was attempted in pregnant women with the 75gGTT, sensitivity and specificity were highest in the plasma glucose level at the one hour point. 5) GDM was found in the group of patients with plasma glucose levels of 155mg/dl or higher determined by GCT; the incidence was high in patients with plasma glucose levels of 160mg/dl or higher.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pregnancy outcome among women universally screened for gestational diabetes mellitus with a lime-flavoured drink

We performed a prospective study involving 400 consecutive pregnant patients to determine whether the administration of a lime-flavoured glucose drink followed by a blood test 1 h later was a better method of screening for gestational diabetes (GDM) than the use of selective screening based on risk factors (maternal age over 30 years, East Indian ancestry and obesity). Complete data were available for 388 women, 76 were screen positive (1 h blood glucose ≥ 140 mg/dl) and GDM was diagnosed in 42 (using a 75 g oral glucose tolerance test) giving a positive predictive value of 55%. Selective screening applied to the same population would have identified only 34 cases, eight fewer with GDM. In this population, the use of the lime-flavoured glucose drink detected approximately 25% more cases of GDM than selective screening based on risk factors. Caesarean sections were performed in 18 (42.8%) of women with gestational diabetes. None of the four perinatal deaths was observed among the women with gestational diabetes.     

Screening for gestational diabetes mellitus in adolescent Hispanic Americans

OBJECTIVE: To determine the incidence of gestational diabetes mellitus (GDM) in an adolescent Hispanic American population. STUDY DESIGN: A retrospective review of 326 women < 20 years of age who identified themselves as Hispanic American was conducted and the incidence of gestational diabetes determined. RESULTS: Thirty adolescent Hispanic Americans (9.2%) had an abnormal result (> or = 140 mg/dL) after 50-g, one-hour oral glucose challenge testing. These women underwent three-hour oral glucose tolerance tests, and five met the criteria for GDM. The incidence of GDM in this population was 1.5% (5/326) (95% confidence interval, 0.6, 3.7). CONCLUSION: The incidence of GDM in adolescent Hispanic Americans is so low that universal screening may not be warranted.     

Incidence of gestational diabetes and birth complications in Switzerland: screening in 1042 pregnancies

To evaluate the incidence of gestational diabetes mellitus (GDM), gestational glucose intolerance (GGI), and birth major complications, a population of 1042 pregnant women was screened after the end of the second trimester with a two-step screening method. Patients with a positive 50-g screening test (plasma glucose ≥7.8?mmol/l at 1?h) underwent a 3-h standard 100-g oral glucose tolerance test. Clinical records of patients and newborns were analysed and compared to normotolerant patients group. GDM was found in 4.8% and GGI in 2.6% of all screened women of this study population. The patient group with GDM significantly differed from control, with a higher proportion of Asiatic women (32.0% versus 2.9%, p?=?0.001) and high prevalence of previous GDM (26.0% versus 0.0%, p?相似文献   

Gestational diabetes: fasting and postprandial glucose as first prenatal screening tests in a high-risk population

OBJECTIVE: To evaluate the value of fasting (FPG) and 2-hour postprandial (PPG) plasma glucose as screening tests for gestational diabetes mellitus (GDM) in a high-risk population during early pregnancy. STUDY DESIGN: At their first prenatal visit, 708 women underwent FPG and PPG for universal screening for GDM, with the diagnosis confirmed by the 75-g oral glucose tolerance test (World Health Organization criteria). The area under the receiver operating characteristic curve (AUC) was used to analyze the performance of the 2 screening tests. RESULTS: Of 184 (25.9%) women with GDM, 79 (42.9%) were identified before 18 weeks. The AUC for FPG to predict GDM was 0.579 (95% CI 0.531-0.627). Though a threshold of 85 mg/dL achieved minimally acceptable sensitivity, 79.9%, the corresponding specificity remained poor, 27.5%, with a false positive rate (FPR) of 72.5%. The AUC for PPG was 0.717 (95% CI 0.670-0.765); a cutoff of 95 mg/dL achieved a sensitivity of 79.9% and FPR of 53.1%. CONCLUSION: Though GDM could be diagnosed in > 40% women in early pregnancy at their first prenatal visit, the poor specificity and high FPR of FPG and PPG, alone or in combination, make them unsuitable screening tests for GDM.     

Gestational diabetes in a high-risk population: using the fasting plasma glucose to simplify the diagnostic algorithm

OBJECTIVE: To evaluate the value of fasting plasma glucose (FPG) in screening a high-risk population for gestational diabetes mellitus (GDM). STUDY DESIGN: During an 8-month period, 1685 pregnant women underwent the one-step 75 g oral glucose tolerance test (OGTT) as a part of a universal screening program. The receiver operating characteristic (ROC) curve was used to analyze the performance of the FPG. RESULTS: 333 (19.8%) women had GDM (WHO criteria). The area under the ROC curve of FPG to detect GDM was 0.639 (95% CI 0.603-0.674), which reflected the degree of the FPG histogram overlap in women with and without GDM. A FPG threshold of 4.7 mmol/l reached the minimally acceptable sensitivity of 78.1% with a corresponding unacceptable specificity of 32.2%. 508 (31%) women were below this threshold, at a negative predictive value of 85.6%. The FPG at higher thresholds with acceptable specificity had poor sensitivity and positive predictive value to be useful. CONCLUSION: Though the high false positive rate at any FPG threshold with adequate sensitivity makes the FPG an inappropriate test for GDM screening, the FPG has the potential to avoid nearly one-third of the cumbersome OGTTs at the expense of missing one-fifth of pregnant women with milder GDM.     

Fasting or two-hour postprandial plasma glucose levels in early months of pregnancy as screening tools for gestational diabetes mellitus developing in later months of pregnancy

PURPOSE: The present study was done to find out whether the fasting or 2-hour postprandial plasma glucose (PPPG) levels in early months of pregnancy can be used as screening tools for gestational diabetes mellitus (GDM) developing in later months of pregnancy. BASIC PROCEDURE: Fasting and 2-hour PPPG levels were measured in the early months of pregnancy in 246 women attending the antenatal clinic of the author. All of the women underwent glucose challenge tests with 50 grams of glucose at 24-28 weeks and if the value exceeded 140 mg%, a three-hour oral glucose tolerance test (OGTT) with 100 grams of glucose was performed to diagnose GDM. MAIN FINDINGS: The present study found that the incidence of GDM was 10.5% in the third trimester. Statistical analysis did not show any correlation between fasting and the PPPG values in the early months and GDM in later months of pregnancy. CONCLUSION: Fasting or PPPG values cannot be used as efficient screening tools for GDM developing in the later months of pregnancy.     

妊娠早期母体一般特征联合多项指标预测妊娠期糖尿病发生的可行性

目的:探讨采用妊娠早期母体一般特征联合多项常规孕早期保健血液检查指标的方法预测妊娠期糖尿病(GDM)发生的可行性。方法:回顾分析2013年1月至2014年12月在上海市第一妇婴保健院建卡产检资料完整的8513例单胎妊娠妇女(已排除糖尿病合并妊娠妇女234例)相关资料,包括母体一般特征及孕11~18周抽血化验结果。根据孕24~28周75g糖耐量检查结果分为病例组(GDM组,1087例)及对照组(正常组,7426例)。结果:两组的年龄、体质量指数(BMI)、白细胞总数、血红蛋白量、谷丙转氨酶、血清铁蛋白、促甲状腺素、空腹血糖、糖化血红蛋白和乙肝病毒e抗原比较,差异均有统计学意义(P0.05)。将这些相关指标建立模型进行GDM的预测,准确性为74.79%,假阳性为46%。利用该式对100例排除了糖尿病合并妊娠的早孕妇女进行前瞻性预测,其准确性为81.25%,假阳性率为57.14%。结论:联合分析孕早期母体一般特征及一些常规孕前保健的血液检查结果,可有效预测GDM发生,通过加强对预测阳性孕妇的早期宣教,或可降低GDM发生。     

Guideline use for gestational diabetes mellitus and current screening, diagnostic and management practices in Australian hospitals

A postal questionnaire investigating screening, diagnosis and management practices for gestational diabetes mellitus (GDM) and guidelines use for GDM, was sent to 544 Australian hospitals providing maternity care. Of these, 360 (66%) responded. Guidelines for GDM were available in 127 (39%) hospitals. Screening for GDM was undertaken by 284 (87%) hospitals and of these, 151 (53%) screened all women and 63 (22%) selectively screened women. Half (143, 50%) of the hospitals surveyed screened women using a 50 g oral glucose challenge test (OGCT) and 70 hospitals (25%) used a 75 g OGCT. A 75 g oral glucose tolerance test was most commonly used to diagnose GDM (207; 81%) and 126 hospitals (60%) recommended a 2 hour blood glucose level of > or = 8.0 mmol/l as diagnostic for GDM. In the management of women with GDM, levels for optimal glycaemic control varied. Postpartum testing for diabetes mellitus was recommended by the majority of hospitals (202; 72%). This study has shown the majority of Australian hospitals providing maternity care screening for GDM, but there is little consensus in screening practices.     

Postpartum diabetes screening in women with a history of gestational diabetes

OBJECTIVE: Women with a history of gestational diabetes mellitus (GDM) are at high risk for developing type 2 diabetes (diabetes mellitus, DM). The American Diabetes Association recommends regular postpartum diabetes screening for women with a history of GDM, but the American College of Obstetricians and Gynecologists (ACOG) is not as directive. We sought to examine postpartum glycemic testing in women diagnosed with GDM. METHODS: We conducted an observational cohort study of women diagnosed with GDM at one of two large academic medical centers between 2000 and 2001. Kaplan-Meier estimates of the time from delivery to the first postpartum DM screening tests were determined, and predictors of postpartum DM screening were examined using Cox proportional hazards testing. RESULTS: Only 37% of eligible women underwent the postpartum diabetes screening tests recommended by the American Diabetes Association (fasting glucose or oral glucose tolerance test [OGTT]), with a median time from delivery to the first such testing of 428 days. By comparison, 94% of women underwent postpartum cervical cancer screening using a Papanicolaou (Pap) test, with a median time from delivery to Pap testing of 49 days. Even when random glucose testing was included in a broad definition of postpartum DM screening (random or fasting glucose, glycosylated hemoglobin, or OGTT), only two thirds of women (67%) received a postpartum glycemic assessment. CONCLUSION: In the population studied, only 37% of women with a history of GDM were screened for postpartum DM according to guidelines published by the American Diabetes Association. Efforts to improve postpartum DM screening in this high-risk group are warranted.     

Diagnostic of gestational diabetes mellitus and the prevalence of LGA (Large for Gestational Age)

OBJECTIVES: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance, first time detected in pregnancy. Early diagnosis of the disease may reduce fetal exposure to maternal hyperglycemia and decrease the risk of LGA. The aim of the study was to examine the influence of time and diagnostic method of GDM on the prevalence of LGA and pregnancy outcome among patients with gestational diabetes. MATERIAL AND METHODS: The study was conducted among 211 women with gestational diabetes mellitus, the patients of 1st Clinic of Obstetrics and Gynecology at the Medical University in Warsaw. We have reviewed the results of fasting plasma glucose, 50-g glucose screening test (GCT) and 2 hour 75-g glucose tolerance test in GDM patients with LGA and eutrophic newborns. The t-student or the Mann-Whitney test was used in order to compare both groups. P<0.05 was deemed statistically significant. RESULTS: LGA was diagnosed in 10.4% of patients. We did not find any significant differences in gestational age when GDM was diagnosed, results of fasting glucose GCT and OGTT among LGA (M) and control (K) group. However, when we compared the percentage of LGA in groups of women with different time of GDM diagnosis, the highest prevalence was noted in the group of first trimester diagnosis and between 28 and 32 weeks of pregnancy, which we found interesting. We compared the women and the results of the diagnostic tests with the group of standard time of GDM diagnosis (24-28 week of pregnancy) and the only difference was the late diagnosis. If 75-g glucose tolerance test had not included 1-hour after load glucose assignment, GDM would not have been diagnosed at all in 18.2% of female patients with LGA. We have not found any correlations between the results of the diagnostic tests, the time of the diagnosis or the mode of treatment GDM (diet alone or with insulin) and the birth weight. CONCLUSIONS: 1. Results of fasting glucose and glucose tolerance tests are not useful in the prediction of LGA in GDM pregnancies. 2. Diagnosis of GDM during the recommended period (between 24 and 28 weeks of pregnancy) may decrease the prevalence of LGA (comparing to later diagnostics). 3. 75-g glucose tolerance test should provide fasting, 1 and 2-hour after load glucose assignment.     

Fasting capillary glucose as a screening test for gestational diabetes mellitus

Objective  To evaluate fasting capillary glucose as a screening test for gestational diabetes mellitus (GDM) compared with traditional risk factors and repeated random capillary glucose measurements.
Design  Cross-sectional, population-based study.
Setting  Maternal Health Care Clinics in Örebro County, Sweden.
Population  An unselected population of women without diabetes.
Methods  Fasting capillary glucose levels were measured at gestational weeks 28–32. Random capillary glucose levels were measured four to six times during pregnancy. Traditional risk factors for GDM were registered. GDM was diagnosed using a 75-g oral glucose tolerance test.
Main outcome measures  Sensitivity, specificity, likelihood ratios.
Results  In 55 of 3616 women participating in the study, GDM was diagnosed before 34 weeks of gestation. For fasting capillary glucose cutoff values between 4.0 and 5.0 mmol/l, sensitivity was in the range between 87 and 47% and specificity between 51 and 96%. Using a combined screening model of traditional risk factors with fasting capillary glucose at various cutoff values increased the sensitivity only slightly compared with using fasting capillary glucose alone.
Conclusion  In this Swedish, unselected, low-risk population, fasting capillary glucose measurements were found to be an acceptable and useful screening test for GDM.     

Postpartum screening for diabetes after a gestational diabetes mellitus-affected pregnancy

OBJECTIVE: To estimate trends in postpartum glucose testing in a cohort of women with gestational diabetes mellitus (GDM). METHODS: A validated computerized algorithm using Kaiser Permanente Northwest automated data systems identified 36,251 live births or stillbirths from 1999 through 2006. The annual percentage of pregnancies complicated by gestational diabetes with clinician orders for and completion of a fasting plasma glucose (FPG) test within 3 months of delivery was calculated. Logistic regression with generalized estimating equations was used to test for statistically significant trends. RESULTS: The percentages of pregnancies affected by GDM increased from 2.9% in 1999 to 3.6% in 2006 (P<.01). Clinician orders for postpartum tests increased from 15.9% in 1999 to 79.3% in 2004 (P<.01), and then remained stable through 2006. Completed FPG tests increased from 9.0% in 1999 to 57.8% in 2004 (P<.01), and then remained stable through 2006. No oral glucose tolerance tests were ordered. From 2004 to 2006, the practice site where women received care was the factor most strongly associated with the clinician order, but it was not predictive of test completion. Among women with clinician orders, those who were Asian or Hispanic or who attended the 6-week postpartum examination were more likely to complete the test than their counterparts. CONCLUSION: Postpartum glucose testing in women with GDM-affected pregnancies increased over time. However, even in recent years, 42% of women with GDM-affected pregnancies failed to have a postpartum FPG test, and no test was ordered for 21% of GDM-affected pregnancies.     

Screening for gestational diabetes mellitus: can we be more efficient?

In a retrospective review of 471 patients screened for gestational diabetes mellitus (GDM) in a community laboratory, we compared 50 g polycose screening test results with those of the 75 g oral glucose tolerance test (GTT). The rate of GDM diagnosis was compared using criteria promulgated by the New Zealand Society for Study of Diabetes (NZSSD), Australian Diabetes in Pregnancy Society (ADIPS) and World Health Organisation (WHO). In those with borderline screening results (7.8-8 mmol/L) the rate of GDM diagnosis using NZSSD criteria was low (2.8%) compared with higher screening test results (> or = 8.1 mmol/L), where the rate was 7.4%. Corresponding rates were 7.5% and 13.5% using ADIPS criteria and 5.6% and 12.4% using WHO criteria. The predictive value of a positive 50 g screening test is therefore low, especially for the higher New Zealand criteria. In women with borderline screening results no subject had a two-hour plasma glucose of 9.0 mmol/L or more on oral GTT. This suggests that the current screening cut-off of 7.8 mmol/L might be raised to 8.1 mmol/L, resulting in a 25% reduction in the number of glucose tolerance tests. Those with significant risk factors such as macrosomia, however, still warrant greater clinical suspicion and closer follow-up.     

Screening for gestational diabetes at antenatal booking in a Malaysian university hospital: the role of risk factors and threshold value for the 50-g glucose challenge test

BACKGROUND: The best method of screening for gestational diabetes (GDM) remains unsettled. The 50-g glucose challenge test (GCT) is used in a two-stage screening process but its best threshold value can vary according to population. AIMS: To evaluate the role of risk factors in conjunction with GCT and to determine an appropriate threshold for the one-hour venous plasma glucose with the GCT. METHOD: In a prospective study, 1600 women at antenatal booking without a history of diabetes mellitus or GDM filled a form on risk factors before GCT. Women who had GCT >or= 7.2 mmol/L underwent the 75-g oral glucose tolerance test (OGTT). GDM was diagnosed according to WHO (1999) criteria. RESULT: Thirty-five per cent had GCT >or= 7.2 mmol/L, 32.6% underwent OGTT and 34.5% of OGTT confirmed GDM. The GDM rate in our population was at least 11.4%. Examination of the receiver operator characteristic curve suggested that the best threshold value for the GCT in our population was >or= 7.6 mmol/L. Multivariable logistic regression demonstrated that only GCT >or= 7.6 mmol/L was an independent predictor for GDM (adjusted odds ratio 3.7: P < 0.001). After GCT, maternal age and anthropometry, OGTT during the third trimester, family history, obstetric history and glycosuria were not independent predictors of GDM. CONCLUSIONS: Risk factors were not independent predictors of GDM in women with GCT >or= 7.2 mmol/L. GCT threshold value >or= 7.6 mmol is appropriate for the Malaysian population at high risk of GDM.     

妊娠期糖尿病的筛查

目的 对妊娠期糖尿病(GDM)筛查的必要性、适宜时间、临界值及巨大儿的发生进行探讨。方法 回顾性分析1997年10月至1999年9月在北京协和医院行产前检查及分娩的1935例初产妇,孕1～4次。结果 妊娠期糖耐量低减(IGT)及GDM的发生率在孕24周以后无差异。OGT异常者分娩巨大儿较葡萄糖负荷试验(OGT)正常者高。50g糖筛查值在7.8～8.3mmol/L(140～149 mg/dl)的159例孕妇,只有2例诊为IGT,无一例为GDM。结论 在孕24周以后尽可能早地对孕妇进行50g糖筛查是必要的。对于OGT异常者应予以重视,对IGT及GDM者应积极控制血糖。对于高危人群必要时重复筛查。     

Gestational Diabetes Mellitus and Postpartum Care Practices of Nurse‐Midwives

Introduction : Postpartum screening for glucose intolerance among women with recent histories of gestational diabetes mellitus (GDM) is important for identifying women with continued glucose intolerance after birth, yet screening rates are suboptimal. In a thorough review of the literature, we found no studies of screening practices among certified nurse‐midwives (CNMs). The objectives of our study were to estimate the prevalence of postpartum screening for abnormal glucose tolerance and related care by CNMs for women with recent histories of GDM and to identify strategies for improvement. Methods : From October through December 2010, the Ohio Department of Health sent a survey by mail and Internet to all licensed CNMs practicing in Ohio. We calculated prevalence estimates for knowledge, attitudes, clinical practices, and behaviors related to postpartum diabetes screening. Chi‐square statistics were used to assess differences in self‐reported clinical behaviors by frequency of postpartum screening. Results : Of the 146 CNMs who provided postpartum care and responded to the survey (62.2% response rate), 50.4% reported screening women with GDM‐affected pregnancies for abnormal glucose tolerance at the postpartum visit. Of CNMs who screened postpartum, only 48.4% used fasting blood sugar or the 2‐hour oral glucose tolerance test. Although 86.2% of all responding CNMs reported that they inform women with recent histories of GDM of their increased risk for type 2 diabetes mellitus, only 63.1% counseled these women to exercise regularly and 23.3% reported referring overweight/obese women to a diet support group or other nutrition counseling. CNMs reported that identification of community resources for lifestyle interventions and additional training in postpartum screening guidelines may help to improve postpartum care. Discussion : CNMs in Ohio reported suboptimal levels of postpartum diabetes testing and use of a recommended postpartum test. Providing CNMs with additional training and identifying community resources to support needed lifestyle behavior change may improve care for women with recent GDM‐affected pregnancies.     

Gestational diabetes mellitus and neonatal hyperthyrotropinemia

OBJECTIVE: To determine whether gestational diabetes mellitus (GDM) is associated with increased incidence of neonatal hyperthyrotropinemia. STUDY DESIGN: In a retrospective study, maternal characteristics, infant outcome and cord blood thyrotropin (TSH) concentration were compared between 469 diet-treated GDM pregnancies diagnosed by the World Health Organization 75 g oral glucose tolerance test (OGTT) with 474 non-diabetic pregnancies with normal OGTT results. RESULTS: Hyperthyrotropinemia (TSH >16 mIU/l) was found in 7.2% of the GDM pregnancies and 2.1% of the controls (p < 0.001), but there was no difference in the birth weight or gestational age. The TSH concentration was correlated with the OGTT 2-hour glucose value (rho = 0.0948, p = 0.029) and Apgar score at the fifth minute (rho = -0.1197, p = 0.009). There was no difference in the TSH or free thyroxine concentrations between the hyperthyrotropinemic newborns of the GDM and control groups. In the GDM group, the hyperthyrotropinemic newborns had a higher incidence (p = 0.017) of neonatal jaundice. CONCLUSIONS: Neonatal hyperthyrotropinemia is more frequently found in pregnancies with GDM, and this could have reflected increased fetal in-utero hypoxic stress in these pregnancies.