ASSOCIATION BETWEEN ABNORMAL GLUCOSE-TOLERANCE (HYPERGLYCEMIA AND HYPOGLYCEMIA) AND ESTRIOL EXCRETION IN PREGNANCY

In 2000 consecutive patients having glucose tolerance tests in pregnancy hyperglycemia (.gtoreq. 95th percentile) was associated with increased placental weight (P < 0.01) but not with increased fetal birth weight. Patients with hypoglycemia (.ltoreq. 5th percentile) were more likely to have small-for-dates babies (P < 0.01). Perinatal death was related to maternal glucose tolerance, being reduced from 1.3% in the total series to 0.6% when normoglycemia was present (P < 0.05); it was significantly increased in the presence of maternal hyperglycemia (P < 0.001) and hypoglycemia (P < 0.01). A combination of abnormal glucose tolerance and subnormal estriol excretion detected pregnancies with significantly higher incidences of fetal and placental growth retardation, major fetal malformations and perinatal deaths. The combination of normoglycemia and normal estriol excretion (62.3% of patients) was associated with a very favorable pregnancy outcome (0.4% perinatal death rate). Hypoglycemia was at least as significant as hyperglycemia in terms of unfavorable pregnancy outcome, especially when associated with subnormal estriol excretion.