scholarly journals Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana

2021 ◽  
Vol 11 (2) ◽  
pp. 257-271
Author(s):  
Faith Agbozo ◽  
Abdulai Abubakari ◽  
Francis Zotor ◽  
Albrecht Jahn
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Birth Asphyxia ◽  
Obstetric Outcomes ◽  
Oral Glucose

The surge in gestational diabetes mellitus (GDM) globally requires a health system tailored approach towards prevention, detection and management. We estimated the prevalence of GDM using diverse recommended tests and diagnostic thresholds, and also assessed the risk factors and obstetric outcomes, including postpartum glycemia. Using a prospective cohort design, 446 singleton pregnant women without pre-existing diabetes did GDM tests in five hospitals in Ghana from 20–34 weeks using fasting plasma glucose (FPG), one-hour and 2-h oral glucose tolerance test (OGTT). Birth outcomes of 403 were assessed. GDM was diagnosed using six international diagnostic criteria. At 12 weeks postpartum, impaired fasting glucose (6.1–6.9 mmol/L) and diabetes (FPG ≥7.0 mmol/L) were measured for 100 women. Per FPG and 2-h OGTT cut-offs, GDM prevalence ranged between 8.3–23.8% and 4.4–14.3%, respectively. Risk factors included overweight (OR = 2.13, 95% CI: 1.13–4.03), previous miscarriage (OR = 4.01, 95% CI: 1.09–14.76) and high caloric intake (OR = 2.91, 95% CI: 1.05–8.07). Perineal tear (RR = 2.91, 95% CI: 1.08–5.57) and birth asphyxia (RR = 3.24, 95% CI: 1.01–10.45) were the associated perinatal outcomes. At 12 weeks postpartum, 15% had impaired fasting glucose, and 5% had diabetes. Tackling modifiable risk factors is crucial for prevention. Glycemic monitoring needs to be integral in postpartum and well-child reviews.

scholarly journals Prevalence of gestational diabetes mellitus and perinatal outcome: a rural tertiary teaching hospital based study

2017 ◽  
Vol 6 (8) ◽  
pp. 3594 ◽  
Author(s):  
Ke Manga Reddy ◽  
Lakshmi Sailaja P. ◽  
Sahithi Balmuri ◽  
Avinash Jagarlamudi ◽  
Kalpana Betha
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Teaching Hospital ◽  
Perinatal Outcome ◽  
Oral Glucose ◽  
Increased Risk ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

Background: Gestational diabetes mellitus is the commonest medical disorder in pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. Prevalence of GDM is known to vary widely depending on region of the country, dietary habits and socio-economic status. This study was undertaken to evaluate the prevalence of GDM and risk factors associated with it among women delivered in a rural tertiary teaching hospital in Telangana and further assess its impact on feto-maternal outcome.Methods: A retrospective study was conducted at Mediciti Institute of Medical Sciences on GDM cases delivered from May 2015 to April 2017. GDM was diagnosed using 2 step procedure of screening with glucose challenge test followed by confirmation with oral glucose tolerance test using Carpenter and Couston criteria. Demographic data and details about perinatal outcome were obtained from medical records and analyzed.Results: The prevalence was low (1.83%) compared to other studies. Majority of the women did not have risk factors. Preeclampsia is the commonest maternal complication seen (18%). Hypothyroidism is more often associated with GDM (15%). Caesarean section rate was high (62%). Though the NICU admission rate was high (76%), neonatal outcome was found to be satisfactory.Conclusions: The low prevalence of GDM seen highlights the importance of carrying out studies in different population groups of India to know the exact prevalence of GDM in the country. Pregnancies in women with GDM continue to be at increased risk of maternal and perinatal complications.

scholarly journals Comparative analysis of current diagnostic criteria for gestational diabetes mellitus

2012 ◽  
Vol 5 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mariya V Boyadzhieva ◽  
Iliana Atanasova ◽  
Sabina Zacharieva ◽  
Tsvetalina Tankova ◽  
Violeta Dimitrova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
International Association ◽  
Study Groups ◽  
World Health ◽  
Oral Glucose ◽  
Significant Difference ◽  
Iadpsg Criteria

Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% ( P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.

scholarly journals Risk Factors for Pregnancy Complications and Postpartum Glucose Intolerance in Women With Gestational Diabetes Mellitus

2020 ◽  
Author(s):  
Naohisa Masuko ◽  
Kenji Tanimura ◽  
Nobue Kojima ◽  
Hitomi Imafuku ◽  
Masashi Deguchi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Intolerance ◽  
Pregnancy Complications ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Hba1c Levels

Abstract This prospective cohort study aimed to evaluate the risk factors for pregnancy complications and postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM). A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery. Clinical factors and parameters in the antepartum 75-g OGTT associated with pregnancy complications and postpartum GI were evaluated. Women with GDM experienced pregnancy complications, including hypertensive disorders of pregnancy (HDP, n=19), preterm delivery (PD, n=17), heavy-for-date (HFD, n=19), and light-for-date (LFD, n=12), and 22 of the 115 women with GDM developed postpartum GI. The univariate and multivariable logistic regression analyses revealed the following risk factors: histories of hypertension (odds ratio [OR], 23.8; 95% confidence interval [CI], 4.2–134.7; p<0.01) for HDP; histories of hypertension (OR, 9.8; 95% CI, 2.5–38.9; p<0.01) for PD; HbA1c levels (OR, 7.6; 95% CI, 1.5–37.9; p<0.05) for HFD; and oral deposition index (DI) (OR, 0.1; 95% CI, 0.02–0.7; p<0.01) for postpartum GI. Higher HbA1c levels and lower oral DI on the antepartum 75-g OGTT may be useful markers for identifying GDM women who are at high risk for HFD and postpartum GI, respectively.

Incidence of Risk Factors on the Onset of Gestational Diabetes Mellitus

2012 ◽  
Vol 2 (3) ◽  
pp. 8-22
Author(s):  
E. De Franchis ◽  
A. Ferramosca ◽  
V. Zara ◽  
L. Piper
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Close Association ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Total Period

In this study the authors evaluated the prevalence of Gestational Diabetes Mellitus (GDM) and the incidence in determining the occurrence thereof, given by the following risk factors: age, family history for Diabetes Mellitus (DM), Body Mass Index (BMI), smoking, diet, macrosomia in previous pregnancies and physical activity. To this end, they investigated a cohort of 61 pregnant women, who had at least one risk factor, in a total period of nine months, during which women checked in the Clinic of Endocrinology and Diabetology of the Hospital “F. Ferrari” in Casarano (Lecce) Italy, and were subjected to an anamnestic investigation and then to a diagnostic test (Oral Glucose Tolerance Test, OGTT 75 g). The anamnesis has allowed to identify the type of risk factors that are present in the population, while the OGTT has allowed to diagnose gestational diabetes. Later, an analysis of the cross-collected data was performed in order to evaluate the percentage incidence of the disease, in relation to risk factors observed. The authors’ results confirmed a prevalence of GDM of 26.23% and the existence of a close association between risk factors and GDM. In particular, the risk factors, macrosomia, BMI = 25 kg/m2, a hypercaloric diet, light physical activity, and age = 35 years, seem to have more influence than smoking and family history for DM, inducing the onset of the illness.

scholarly journals How does antenatal lifestyle affect the risk for gestational diabetes mellitus? A secondary cohort analysis from the GeliS trial

2021 ◽  
Author(s):  
Julia Günther ◽  
Julia Hoffmann ◽  
Lynne Stecher ◽  
Monika Spies ◽  
Kristina Geyer ◽  
...  
Keyword(s):  
Mental Health ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Vigorous Physical Activity ◽  
Significant Risk ◽  
Well Being ◽  
Oral Glucose

Abstract Objectives We aimed to investigate the predictive potential of early pregnancy factors such as lifestyle, gestational weight gain (GWG) and mental well-being on gestational diabetes mellitus (GDM) beyond established risk factors. Methods GDM risk was investigated in the cohort of the German ‘Gesund leben in der Schwangerschaft’/healthy living in pregnancy study. Women were recruited up to the 12th week of gestation. GDM was diagnosed with a 75 g oral glucose tolerance test between the 24th and 28th weeks of gestation. Pre-pregnancy age and weight, mental health and lifestyle were assessed via questionnaires. Maternal weight was measured throughout pregnancy. Early excessive GWG was defined based on the guidelines of the Institute of Medicine. The association between several factors and the odds of developing GDM was assessed using multiple logistic regression analyses. Results Of 1694 included women, 10.8% developed GDM. The odds increased with pre-pregnancy BMI and age (women with obesity: 4.91, CI 3.35–7.19, p < 0.001; women aged 36–43 years: 2.84, CI 1.45–5.56, p = 0.002). Early excessive GWG, mental health and general lifestyle ratings were no significant risk factors. A 31% reduction in the odds of GDM was observed when <30% of energy was consumed from fat (OR 0.69, CI 0.49–0.96, p = 0.026). Vigorous physical activity tended to lower the odds without evidence of statistical significance (OR 0.59 per 10 MET-h/week, p = 0.076). Conclusions Maternal age and BMI stand out as the most important drivers of GDM. Early pregnancy factors like dietary fat content seem to be associated with GDM risk. Further evaluation is warranted before providing reliable recommendations.

scholarly journals To study the incidence of gestational diabetes mellitus and risk factors associated with GDM

2017 ◽  
Vol 4 (1) ◽  
pp. 112 ◽  
Author(s):  
Maxima Anand ◽  
Manan Anand ◽  
Devinder Singh Mahajan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Challenge Test ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
Glucose Levels ◽  
History Of

Background: Diabetes is estimated to complicate 2-5% of all pregnancies of which 90% of those are detected during pregnancy i.e. gestational diabetes mellitus (GDM) and the rest are overt or pregestational i.e. either Type 1 or Type 2. According to ADA, approximately 7% of all pregnancies are complicated by GDM resulting in more than 2,00,000 cases annually. The aim was to study the incidence of GDM among pregnant women between 24 to 28 weeks of gestation, to evaluate and compare the occurrence of risk factors e.g.; family history of diabetes, prematurity, history of foetal loss and congenital anomaly associated with diabetes in pregnancy.Methods: 50gm of glucose, glucose challenge test (GCT) was given to women coming for antenatal check-up between 24 to 28 weeks of gestation irrespective of presence or absence of risk factors for GDM.1 hour glucose levels were checked. Patients with glucose levels more than 130mg/dl were subjected to 100gm of oral glucose tolerance test (OGTT) according to Carpenter and Coustan modification of the National Diabetes Data. Data was compiled and statistically analysed.Results: In this study it was observed that 20 (women had raised GCT, 11 (5.3%) women developed GDM out of 206 women. All GDM patients have one or more risk factors. Age >25 years (63.6%) fetal loss (36.3%), BMI (33.3%) are common risk factors followed by family history of diabetes (27.3%).Conclusions: Family history of diabetes and past history of congenital anomalies are statistically significant in GDM group as compared to non GDM.

scholarly journals ОLD VERSUS NEW RUSSIAN CRITERIA FOR GESTATIONAL DIABETES

2013 ◽  
Vol 19 (4) ◽  
pp. 367-373
Author(s):  
P. V. Popova ◽  
A. V. Dronova ◽  
E. R. Sadikova ◽  
M. P. Parkkinen ◽  
M. V. Bolshakova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fasting Glucose ◽  
Fasting Blood Glucose ◽  
Prenatal Visit ◽  
Iadpsg Criteria ◽  
New Criteria

Objective. To compare the incidence of gestational diabetes mellitus (GDM), risk factors of its development when using the old (WHO, 1999) and the new Russian criteria (2012) and to assess the correspondence between fasting glycaemia and 75-g oral glucose tolerance test (OGTT), under the new criteria.Design and methods. A total of 354 pregnant women were screened for gestational diabetes mellitus by OGTT between weeks 24 and 28 of gestation. Fasting blood glucose at irst prenatal visit was obtained from the medical records. GDM for therapy initiation was diagnosed according to WHO criteria. GDM was also retrospectively deined according to the new IADPSG-criteria (fasting plasma glucose >5,1 and < 7,0 mmol/l at the irst prenatal visit or by OGTT fasting glucose >5,1 and/or ? 10,0 mmol/l after 1 hour and/or ? 8,5 mmol/l after 2 hours at 24–32 gestation week). Results. GDM was detected in 25,1 % according to the old criteria and in 26,8 % women under the new criteria by OGTT. Fasting glucose at the irst prenatal visit between 5,1 mmol/l and 7,0 mmol/l (that is, GDM under the new criteria) was deined in 92 (28,1 %) of 327 women with known fasting blood glucose level. Only in 34 (37 %) of 92 women with fasting glycemia > 5,1 mmol/l at the irst prenatal visit the results of OGTT met the criteria for GDM (IADPSG) at 24–28 weeks gestation. Total incidence of GDM according to the new criteria (at the irst prenatal visit and after 24 weeks of pregnancy) was 43,4 %. Conclusions. Application of the new Russian criteria leads to a signiicant increase in the frequency of GDM, mainly due to the fasting glucose level at the irst prenatal visit. In women with GDM, diagnosed according to the IADPSG-criteria (but not WHO), such risk factors of GDM as heredity for diabetes mellitus and hypertension before pregnancy were more often identiied compared with women without GDM.

scholarly journals Pregnancy outcome among gestational diabetes mellitus patients in a tertiary care centre

2020 ◽  
Vol 9 (3) ◽  
pp. 942
Author(s):  
Jesu Thangam M. ◽  
Jameela Ponmalar A. R. ◽  
Vishnupriya S.
Keyword(s):  
Diabetes Mellitus ◽  
Intensive Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Obstetric Outcomes ◽  
Oral Glucose ◽  
Tertiary Care Centre

Background: Gestational diabetes mellitus poses numerous health problems for both mother and the fetus. Even though there are improved outcomes, complications of gestational diabetes still persists. Objectives of this study was to find out the maternal and perinatal outcomes in gestational diabetes mellitus.Methods: This study was done among pregnant women attending antenatal outpatient department at Sree Mookambika Institute of Medical Sciences, Kulasekharam. oral glucose tolerance test was done at between 24 to 28 weeks and the values more than their cutoff was labelled as gestational diabetes and their outcome was measured as complications during antenatal period, mode of delivery and perinatal outcome in view of neonatal intensive care unit admissions due to hyperbilirubinemia and respiratory distress syndrome.Results: Out of 500 antenatal mothers 65 were found to have gestational diabetes which is approximately 13%. Obstetric outcomes were 10% of them developed pregnancy induced hypertension, 12% of them ended in preterm labour and polyhydramnios in 2%. Delivery by caesarean section and vaginal route is almost similar. Maximum number of neonatal intensive care admissions are due to hyperbilirubinemia followed by respiratory distress.Conclusions: Screening for gestational diabetes and adequate glycemic control is necessary in preventing short term and long-term complications.

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