The HAPO (Hyperglycemia and Adverse Pregnancy Outcomes) study demonstrated a continuous relationship between maternal glucose and adverse perinatal outcomes. Which primary outcome showed the STRONGEST continuous association with maternal fasting plasma glucose?
- A Preterm birth before 34 weeks
- B Neonatal respiratory distress syndrome
- C Birth weight > 90th percentile (large for gestational age) ✓
- D Maternal cesarean delivery rate
Correct answer: C. Birth weight > 90th percentile (large for gestational age)
Explanation
The HAPO study (NEJM 2008) followed 23,316 pregnant women across 15 centres and found that increasing maternal glucose levels (fasting, 1-hour, and 2-hour after 75 g OGTT) were continuously and independently associated with primary outcomes. Birth weight above the 90th percentile (LGA) showed the strongest and most consistent association with fasting glucose, 1-hour, and 2-hour values. This study provided the evidence base for the IADPSG diagnostic thresholds for GDM.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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