Background: Abnormalities in glucose metabolism during pregnancy can lead to significant adverse perinatal outcomes, while the effect of minor glucose metabolism abnormalities is poorly understood.    Objectives: This study was designed to investigate the impact of a +ve glucose challenge test on perinatal morbidity.    
Patients and methods: This is a prospective cohort study at Ain Shams University Maternity Hospital that included 200 pregnant women with singleton pregnancies at 24-28 weeks of gestation. These patients were at high risk of developing GDM. A glucose challenge test (GCT) was done on all patients. It was divided according to results into two groups of 100 patients each, a group with positive (GCT) and negative 100 gm glucose tolerance test, and a group 2 patients with negative (GCT) All patients were followed till delivery, documenting adverse maternal or perinatal outcomes. The primary outcome was fetal macrosomia, while secondary outcomes were shoulder dystocia, preterm labor, pregnancy-induced hypertension, NICU admission, and neonatal death.   Results: Among 200 patients included in the study, BMI was 30.17±4.48 in the study group vs 28.31±4.5 in the control group with a P value of 0.004, macrosomia was in 22 (22%) in the study group vs 7 (7%) in the control group. And 19 (19%) cases in the study group need NICU admission vs. 10 (10%) cases in the control group with a P value of 0.032. No significant differences were observed between study groups as regards age, GA, parity, APGAR score at 5 min, shoulder dystocia, PTL, PIH, and neonatal death.  Conclusion: A positive oral glucose challenge test only without gestational diabetes is a risk factor for perinatal morbidity like LGA and NICU admission, so early screening for  GDM is advisable.