203-OR: Metabolic and Clinical Outcomes with One Abnormal Value on Carpenter Coustan Criteria

Objective: To examine the metabolic profile and neonatal outcomes of 1 abnormal (1ABNL) value on a 100g OGTT using Carpenter Coustan (CC) compared to no GDM (NGDM) and treated GDM (GDM) by the IADPSG or CC Criteria. Methods: This is a secondary analysis of an RCT of GDM diagnosis using the IADPSG or CC criteria. Those with 1ABNL on CC GDM were not treated and compared to NGDM and GDM. Propensity score models with inverse probability of treatment weighing (IPTW) were used to balance groups. Results: Of 827 participants 82 (10%) had 1 ABNL, 80 (10%) had GDM (22% CC, 78% IADPSG), and 665 (80%) NGDM. After IPTW, glucose and insulin were significantly higher whereas insulin sensitivity and beta cell response were lower in 1ABNL vs. NGDM. Insulin sensitivity/resistance and glucose/insulin AUC were similar between 1ABNL vs. GDM (Table) After IPTW, LGA (OR 1.4, 95% CI 1.0-2.0) and maternal composite (OR 2.0, 95% CI 1.6-2.6) were higher while neonatal composite (OR 0.5, 95% CI 0.4-0.7) and SGA (OR 0.1, 95% CI 0.1-0.2) were lower when comparing untreated 1 ABNL vs. NGDM. Compared to GDM, 1ABNL was associated with higher LGA (OR 3.4, 95% CI 1.4-8.4) and lower risk for SGA (OR 0.2, 95% CI 0.1-0.8), and neonatal composite (OR 0.3, 95% CI 0.2-0.6). Conclusions: Women with 1ABNL on a 100g OGTT have a similar metabolic profile compared to GDM but metabolic dysfunction compared to NGDM resulting in increased fetal growth compared to both NGDM and treated GDM. C.M. Scifres: None. E. Davis: None. T. Costacou: None. S.R. Orris: None. C.M. Lalama: None. K. Abebe: None. P. Catalano: None. National Institutes of Health (1R01HD079647)