Gestational diabetes and its correlation with maternal socio-demographic characteristics

Nask Jalal Jubrael; Shahla K Alalaf; Nazar Shabila; Salah Abubaker Ali

doi:10.15218/zjms.2022.021

Authors

Nask Jalal Jubrael Directorate of Health, Erbil, Iraqi Kurdistan Region
Shahla K Alalaf Department of Gynecology and Obstetrics, College of Medicine, Hawler Medical University, Erbil, Iraqi Kurdistan Region
Nazar Shabila College of Health Sciences, Catholic University in Erbil, Erbil, Iraq.
Salah Abubaker Ali Department of Basic Sciences, College of Medicine, Hawler Medical University, Erbil, Iraqi Kurdistan Region

DOI:

https://doi.org/10.15218/zjms.2022.021

Keywords:

Gestational diabetes mellitus, Demographic character, Glucose tolerance test, Prevalence rate

Abstract

Background and objective: Gestational diabetes mellitus is the most common metabolic disorder of pregnancy with increasing prevalence at epidemic rates. This study aimed to determine the prevalence of gestational diabetes mellitus and related risk factors in a sample of pregnant women in Erbil city.

Methods: A cross-sectional study was conducted on a convenience sample of 216 pregnant women at primary health care centers in Erbil city, Kurdistan Region, Iraq, from April 2019 to January 2021. The pregnant women were selected independent of having or not having risk factors. Pregnant women were screened for diabetes mellitus using 50 gm glucose challenge test in 24–28th weeks of gestational age. Women with positive glucose challenge test underwent 100 g glucose tolerance test.

Results: The 50g glucose challenge test revealed that 54 women (25.0%) were positive for gestational diabetes mellitus. Glucose tolerance test (100 gm) revealed that the prevalence of diabetes among the sample was 11.9%. The association between the different characteristics and risk factors with the diagnosed diabetic status of the study participants showed that there was a significant association with the older age, obesity, higher parity, and history of recurrent miscarriage.

Conclusion: Pregnancy is associated with a high prevalence of gestational diabetes mellitus in the current research. Pregnant women, particularly those in advanced maternal age, with pre-pregnancy high body mass index and having a history of recurrent miscarriages, should be investigated for the possibility of the presence of gestational diabetes mellitus.

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References

World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization guideline. 2013. (Accessed June 9, 2017, at http://apps.who.int/iris/bitstream/10665/85975/1/WHO_NMH_MND_13.2_eng.pdf).

Jiwani A, Marseille E, Lohse N, Damm P, Hod M, Kahn JG. Gestational diabetes mellitus: results from a survey of country prevalence and practices. J Matern Fetal Neonatal Med. 2012; 25(6):600–10.

Muche AA, Olayemi OO, Gete YK. Prevalence of gestational diabetes mellitus and associated factors among women attending antenatal care at Gondar town public health facilities, Northwest Ethiopia. BMC Pregnancy Childbirth. 2019; 19:334.

Ogurtsova K, da Rocha Fernandes J, Huang Y, Linnenkamp U, Guariguata L, Cho N, et al. IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017; 128:40–50.

Shou C, Wei YM, Wang C, Yang HX. Updates in Long-term Maternal and Fetal Adverse Effects of Gestational Diabetes Mellitus. Maternal-Fetal Medicine. 2019; 1(2):91–4. https://doi.org/10.1097/FM9.0000000000000019s

Saccone G, Caissutti C, Khalifeh A, Meltzer S, Scifres C, Simhan HN, et al. One step versus two step approach for gestational diabetes screening: systematic review and meta-analysis of the randomized trials. J Matern Fetal Neonatal Med. 2019; 32:1547–55. https://doi.org/10.1080/14767058.2017.1408068

Kayal A, Mohan V, Malanda B, Anjana RM, Bhavadharini B, Mahalakshmi MM, et al. Women in India with GDM Strategy (WINGS) – Methodology and development of Model of Care for GDM (WINGS 4). Indian J Endocrinol Metab. 2016; 20(5):707–15. https://doi.org/10.4103/2230-8210.189230

Minschart C, Beunen K, Benhalima K. An Update on Screening Strategies for Gestational Diabetes Mellitus: A Narrative Review. Diabetes Metab Syndr Obes. 2021; 14:3047–76.

Fitria N, van Asselt AD, Postma MJ. Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review. The Eur J Health Econ. 2019; 20(3):407–17. https://doi.org/10.1007/s10198-018-1006-y

American Diabetes A. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019; 42:S13–28.

Committee on Practice B-O. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018; 131:e49–64.

Moyer VA. Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014; 160:414–20.

Nguyen CL, Pham NM, Binns CW, Duong DV, Lee AH. Prevalence of Gestational Diabetes Mellitus in Eastern and Southeastern Asia: A Systematic Review and Meta-Analysis. J Diabetes Res. 2018; 2018:6536974. https://doi.org/10.1155/2018/6536974

Abu-Heija A, Al-Bash M, Ishrat N, Al-Kharausi L. 50 Grams Oral Glucose Challenge Test: Is It an Effective Screening Test for Gestational Diabetes Mellitus? J Obstet Gynaecol India. 2016; 66(Suppl 1):7–11.

Carreiro MP, Nogueira AI, Ribeiro-Oliveira A. Controversies and Advances in Gestational Diabetes-An Update in the Era of Continuous Glucose Monitoring. J Clin Med. 2018;7:2. https://doi.org/10.3390/jcm7020011

Macaulay S, Dunger DB, Norris SA. Gestational diabetes mellitus in Africa: a systematic review. PLoS One. 2014; 9(6):e97871.

Desisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, pregnancy risk assessment monitoring system (PRAMS), 2007–2010. Prev Chronic Dis. 2014; 11:E104. https://doi.org/10.5888/pcd11.130415

Eades CE, Cameron DM, Evans JM. Prevalence of gestational diabetes mellitus in Europe: a meta-analysis. Diabetes Res Clin Pract. 2017; 129:173–81. https://doi.org/10.1016/j.diabres.2017.03.030

International Diabetes Federation, IDF Diabetes Atlas, 2015. (Accessed July 6, 2021, at https://www.diabetesatlas.org/upload/resources/previous/files/7/IDF%20Diabetes%20Atlas%207th.pdf).

Baz B, Riveline JP, Gautier JF. Endocrinology of pregnancy: Gestational diabetes mellitus: Definition, aetiological and clinical aspects. Eur J Endocrinol. 2016; 174(2):R43–51. https://doi.org/10.1530/EJE-15-0378

Rajput R, Yadav Y, Nanda S, Rajput M. Prevalence of gestational diabetes mellitus & associated risk factors at a tertiary care hospital in Haryana. Indian J Med Res. 2013; 137(4):728–33.

Behboudi-Gandevani S, Amiri M, BidhendiYarandi R, Ramezani Tehrani F. The impact of diagnostic criteria for gestational diabetes on its prevalence: a systematic review and meta-analysis. Diabetol Metab Syndr. 2019; 11:11. https://doi.org/10.1186/s13098-019-0406-1

Logakodie S, Azahadi O, Fuziah P, Norizzati B, Tan SF, Zienna Z, et al. Gestational diabetes mellitus: The prevalence, associated factors and foeto-maternal outcome of women attending antenatal care. Malays Fam Physician. 2017; 12(2):9–17.

Abu-Heija AT, Al-Bash MR, Al-Kalbani MA. Effects of maternal age, parity and pre-pregnancy body mass index on the glucose challenge test and gestational diabetes mellitus. J Taibah Univ Medical Sci. 2017; 12(4):338–42. https://doi.org/10.1016/j.jtumed.2017.01.005

Li G, Wei T, Ni W, Zhang A, Zhang J, Xing Y, et al. Incidence and risk factors of gestational diabetes mellitus: a prospective cohort study in Qingdao, China. Front Endocrinol (Lausanne). 2020; 11:636. https://doi.org/10.3389/fendo.2020.00636