The influence of abnormal glucose tolerance (hyperglycaemia and hypoglycaemia) on pregnancy outcome when oestriol excretion is subnormal

Abstract

Subnormal urinary oestriol excretion was present in 611 (13.9 per cent) of 4403 consecutive patients in whom a glucose tolerance test had been performed and urinary oestriol excretion measured during the third trimester of pregnancy. Hypoglycaemia (less than 5th centile) had a significant association with subnormal oestriol excretion. The perinatal mortality rate was significantly higher in the presence of abnormal glucose tolerance when oestriol excretion was low. Normoglycaemia was associated with a perinatal mortality rate of 1.7 per cent when oestriol excretion was persistently low, whereas in the presence of hyperglycaemia (greater than 95th centile) the perinatal mortality rate was 12.5 per cent (P less than 0.01) and when there was hypoglycaemia the rate was 14.8 per cent (P less than 0.001). Small-fordates babies occurred in 46.3 per cent of pregnancies complicated by hypoglycaemia and persistently subnormal urinary oestriol excretion. The advantage of routine urinary oestriol assay and glucose tolerance testing in pregnancy is emphasized.