Bedeutung eines frühen 75-g-OGTT zur Erkennung von Glukosestörungen bei Hochrisikopatientinnen nach Spätabort oder Frühgeburt

Introduction: This study aimed to determine the proportion of pathological results in the early 75-g OGTT among women with a history of late miscarriage or preterm birth after prophylactic cerclage. The effects of early-diagnosed gestational diabetes on pregnancy outcome, neonatal parameters, preconceptional BMI, and mode of delivery were also analyzed. Methods: In 140 pregnant women, a primary cerclage and a 75-g OGTT were performed between 16 and 21 weeks of gestation. Analysis was based on OGTT results (physiological vs. pathological). The primary endpoint was pregnancy outcome; secondary endpoints included neonatal parameters, preconceptional BMI, and mode of delivery. Results: Eighty-nine women (63%) showed a pathological OGTT result substantially higher than in the general population. This was not significantly associated with late miscarriage or preterm birth (OR 2.18; p=0.13) but showed a trend toward increased risk. Neonatal outcomes were similar between groups. A preconceptional BMI>35 kg/m² was significantly related to a pathological OGTT (p=0.04). Women with a pathological OGTT had more cesarean deliveries (55.8% vs. 35.3%; p=0.02). Conclusion: In this high-risk cohort with a history of late miscarriage or preterm birth, 63% had a pathological early 75-g OGTT, indicating increased susceptibility to glucose metabolism disorders. Early glucose screening and individualized metabolic management are essential to improve pregnancy and perinatal outcomes.