Impaired gestational glucose tolerance. Its effect on placental pathology

OBJECTIVE: The aim of this study was to investigate several macroscopic and microscopic features of placenta in cases with impaired gestational glucose tolerance.

METHODS: Seventy-five gm World Health Organization criteria for the diagnosis of gestational diabetes and impaired gestational glucose tolerance were followed during the period June 1999 through to June 2000, at the Maternity Hospital of Kuwait. Macroscopic and microscopic examinations of 95 placentas were carried out. Sixty-five were from the control patients and 30 were from cases with impaired gestational glucose tolerance.

RESULTS: Mean maternal age, maternal weight and parity was significantly higher in the impaired gestational glucose tolerance (IGGT) group compared to the control group. Mean birth weight of the baby was significantly higher in the IGGT group compared to the control group. Mean placental weight and the percentage of the cesarean delivery was higher in the IGGT group but did not reach the level of significance. There was no significant association between the microscopic features of the placenta in the control and IGGT groups.

CONCLUSION: Impaired gestational glucose tolerance is related to increased neonatal and placental weight, which may lead to a higher number of cesarean deliveries, stressing the similarity between impaired gestational glucose tolerance and gestational diabetes mellitus. More stringent criteria may be necessary to define gestational diabetes. Microscopic features of placenta both in the control and IGGT groups did not show any significant difference.