Prevalence of Gestational Diabetes Mellitus and Its Associated Risk Factors in Boo-Ali Hospital, Tehran
DOI:
https://doi.org/10.31661/gmj.v9i.1642Keywords:
Frequency; Gestational Diabetes Mellitus; Risk FactorsAbstract
Background: Gestational diabetes mellitus (GDM) represents the most common metabolic complication during pregnancy. GDM is associated with maternal and fetal complications. Approximately 7% of all pregnancies are affected by GDM, resulting in more than 200,000 cases worldwide annually, and the prevalence may vary from 1% to 14% among all pregnancies. Accordingly, this study attempted to determine the prevalence and some risk factors of GDM. Materials and Methods: This hospital-based cross-sectional study was carried out at Boo-Ali hospital in Tehran, the capital of Iran. Four hundred non-diabetics pregnant women with a gestational age of 24-28 weeks who attended the Boo-Ali hospital outpatient department were included in our study. Demographic and anthropometric data including age, gravida, para, gestational age, family history of diabetes, history of GDM, weight, height, and body mass index (BMI) were collected. Blood samples were collected from the women at 24-28 weeks to diagnose GDM by oral glucose tolerance test (OGTT). We measured the 25-OH-D level in participants at 24-28 weeks. Results: Among the 400 pregnant women, 46 (11.5%) had GDM based on OGTT, and the mean age of GDM women were 30.78± 5.96 years. Among selected variables, BMI ≥25kg/m2, family history, and GDM history were associated with increased risks of GDM (odds ratio=2.49, 95% confidence interval [CI] 1.22–5.07;3.52, 95% CI 1.84–6.70; 19.57, and 95% CI 6.16–62.17, respectively). The association was more robust in the positive GDM history of women. Conclusion: High prevalence of GDM highlights more attention of health-care givers in screening pregnant women with risk factors. BMI as a modifiable risk factor for GDM needs more attention, and positive family history and previous GDM history should be considered in the core activities of pregnant women. [GMJ.2020;9:e1642]
References
American Diabetes Association. Gestational diabetes mellitus. Diabetes Care. 2014;37(Suppl 1):14-80 Kjos SL BT. Gestational diabetes mellitus. N Engl. J Med. 1999; 341:1749-56. https://doi.org/10.1056/NEJM199912023412307PMid:10580075 Carr DB, Gabbe S. Gestational diabetes: detection, management, and implications. Clinical Diabetes. 1998;16(1):4-12. Sue Kirkman M, Schaffner W. Gestational Diabetes Mellitus: ADA. Diabetes Care. 2012; 35, 941-942. https://doi.org/10.2337/dc12-0164PMid:22517936 PMCid:PMC3329847 Di Cianni G, Miccoli R, Volpe L, Lencioni C, Del Prato S. Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metab Res Rev. 2003; 19:259-70. https://doi.org/10.1002/dmrr.390PMid:12879403 Almasi S-Z, Salehiniya H. The prevalence of gestational diabetes mellitus in Iran (1993-2013): A systematic review, J I.U.M.S. 2014;32(299):1396-412. Janghorbani M, Enjezab B. Review of epidemiology of gestational diabetes in Iran. J I.U.M.S. 2010;28(110):1-16. Sayehmiri F, Bakhtyari S, Darvishi P, et al. prevalence of gestational diabetes mellitus in Iran: a systematic review and meta-analysis study. Iran. J. Obstet. Gynecol. Infertil. 2013; 15:1623. Vakili M, Modaressi M, Razieh Zahabi R, Aghakoochak A. Prevalence of gestational diabetes and its risk factors in Meibod-Yazd 2013-2014.J Commun Health Res. 2016;5(4):270-278. Jafari-Shobeiri M, Ghojazadeh M, Azami-Aghdash S, Naghavi-Behzad M, Piri R, Pourali-Akbar Y, et al. Prevalence and risk factors of gestational diabetes in Iran: a systematic review and meta-analysis. Iran J Public Health. 2015; 44:1036-1044. Khoshnniat Nikoo M, Abbaszadeh Ahranjani S, Larijani B. A review on the prevalence of gestational diabetes mellitus(GDM) in different regions of Iran: Iranian J Diabetes and Lipid Disorders. 2009; 47-56 Garshasbi A, Faghihzadeh S, Naghizadeh MM, Ghavam M. Prevalence and risk factors for gestational diabetes mellitus in Tehran. J Fam Reprod Health. 2008; 2(2):75-80. Momenzadeh F, Mokhlesi S, Mohebbi S, Moghddam Banaem L. Gestational diabetes and its risk factors for pregnant women in Tehran. Int J Trop Med. 2015;10:30-33 American Diabetes Association Gestational diabetes mellitus. Diabetes Care. 2000; 23:77-79. Larijani B, Pajouhi M, Bastanhagh MH, et al. prevalence of gestational diabetes in 2100 women in Tehran. Iranian J Endocrinol Metab. 1999;1(2):125-33. Durman NB. Frequency of gestational diabetes mellitus and the associated risk factors. Park J Med Sci. 2015;31(1): 194-197. https://doi.org/10.12669/pjms.311.5617PMid:25878642 PMCid:PMC4386185 Hillier TA, Pedula KL, Schmidt MM, Mullen JA, Charles M-A, Pettitt DJ. Childhood obesity and metabolic imprinting. Diabetes Care. 2007; 30:2287-2292. https://doi.org/10.2337/dc06-2361PMid:17519427 Group THSCR. Hyperglycemia and adverse pregnancy outcomes. Diabetes. 2009; 58:453-459. https://doi.org/10.2337/db08-1112PMid:19011170 PMCid:PMC2628620 Yumei W, Huixia Y, Weiwei Z, Hongyun Y, Haixia L, Jie Y, et al. International association of diabetes and pregnancy study group criteria is suitable for gestational diabetes mellitus diagnosis: further evidence from China. Chin Med J. 2014; 127:3553-3556. Niyibizi JB, F Safari, JB Ahishakiye, JB Habimana, H Mapira and NC Mutuku, 2016. Gestational diabetes mellitus and its associated risk factors in pregnant women at selected health facilities in Kigali City, Rwanda. J Diabetes Mellitus. 6: 269-276. https://doi.org/10.4236/jdm.2016.64028 Leila J. Gracelyn, Saranya N. Prevalence of gestational diabetes mellitus in antenatal women and its associated risk factors. Int J Reprod Contracept Obstet Gynecol. 2016 Feb;5(2):285-291. https://doi.org/10.18203/2320-1770.ijrcog20160081 Ali AD, Mehrass AA-KO, Al-Adhroey AH, Al-Shammakh AA, Amran AA. Prevalence and risk factors of gestational diabetes mellitus in Yemen. Int J Womens Health. 2016;8: 35-41. https://doi.org/10.2147/IJWH.S97502PMid:26869814 PMCid:PMC4734826 Bibi S, Saleem U, Mahsood N. The frequency of gestational diabetes mellitus and associated risk factors at Khyber teaching hospital Peshawar. J Postgrad Med Inst. 2015; 29(1): 43-6. Schmidt MI, Matos MC, Reichelt AJ, Forti AC, de Lima L, Duncan BB. Prevalence of gestational diadetes mellitus-do new WHO criteria make a difference? Brazilian Gestational Diabetes Study Group. Diabet Med. 2000; 17:376-80 https://doi.org/10.1046/j.1464-5491.2000.00257.xPMid:10872537 Zargar AH, Sheikh MI, Bashir MI, Masoodi SR, Law BA, Wani Al, et al. prevalence of gestational diabetes mellitus in Kashmiri women from the Indian subcontinent. Diabetes Res Clin Pract. 2004;66:139-45 https://doi.org/10.1016/j.diabres.2004.02.023PMid:15533581 Farrant HJ, Krishnaveni GV, Hill JC, et al. Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size. Eur J Clin Nutr. 2009; 63:646-652. https://doi.org/10.1038/ejcn.2008.14PMid:18285809 PMCid:PMC2678985 Makgoba M, Nelson SM, Savvidou M, Messow CM, Nicolaides K, Sattar N. First-trimester circulating 25-hydroxyvitamin d levels and development of gestational diabetes mellitus. Diabetes Care. 2011; 34:1091-1093. https://doi.org/10.2337/dc10-2264PMid:21454797 PMCid:PMC3114479 Maghbooli Z, Hossein-Nezhad A, Mirzaei K, et al. Association between retinol-binding protein 4 concentrations and gestational diabetes mellitus and risk of developing metabolic syndrome after pregnancy. Reprod Sci. 2009; 17:196-201. https://doi.org/10.1177/1933719109351097PMid:19897788 Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F. Maternal vitamin D status in gestational diabetes mellitus. Nutr Clin Pract. 2010; 25:524-527. https://doi.org/10.1177/0884533610379851PMid:20962313
