The Prevalence and Determinants of GDM among Pregnant Women’s in Obstetric Clinics at MCH Makkah City 2019

Ahmed Saleh Alghamdi^1, and Ebtesam Bakheet Allugmani²

¹Family Medicine Resident, Ministry of Health, Saudi Arabia

²Family Medicine Consultant, Ministry of Health, Saudi Arabia

Cite this paper:
Ahmed Saleh Alghamdi and Ebtesam Bakheet Allugmani. The Prevalence and Determinants of GDM among Pregnant Women’s in Obstetric Clinics at MCH Makkah City 2019. American Journal of Medical Sciences and Medicine. 2020; 8(5):187-195. doi: 10.12691/ajmsm-8-5-4

Abstract

Gestational diabetes mellitus (GDM) used to be defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Gestational Diabetes Mellitus (GDM) is the most common metabolic disorder during pregnancy. It is associated with maternal and fetal complications. Screening for GDM and its risk factors is essential for the early diagnosis and management. Recently, the definition has evolved to distinguish women whose condition is a transient manifestation of pregnancy-related insulin resistance from those with probable preexisting diabetes that is first recognized during pregnancy. The physiological and hormonal change during pregnancy can lead to increase insulin resistance and production of glucose, if pancreas cannot secrete sufficient insulin to maintain blood glucose can cause impaired glucose tolerance or gestational diabetes. Aim of the study: This study aimed to evaluate the prevalence of GDM among pregnant women's in the obstetric clinics in MCH at Makkah city. Methodology: analytic cross sectional study was conducted among (147) pregnant women who attend obstetric clinics in the one-month using the simple has been random technique using random table generator. Maternal and children's hospital is the biggest hospital in Makkah and has 3 clinic per day. Results: A total of (170) participated in the study. Regarding age of these Only(46.5%)of the participated were(>35)years, the weight(current) the data ranged from(40to136)by mean +SD(72.905±16.167). While the weight before pregnancy the data ranged from (39to1727)by mean +SD(67.985±15.082). The age a significant relation between diabetic mellitus and age were P-value=0.001and X2(8.860) increase in >35years answer YES were(71.4%). Gravida show a significant relation between diabetic mellitus were P-value=0.036 and X2(10.255) increase in more than 4 answer YES were (57.1%). the gravida/para/abortus (GPA) results show a significant relation between diabetic mellitus and GPA were P-value=0.026 and X2(11.008) increase in zero answer NO were (64.7%). Conclusion: The prevalence of of GDM among pregnant women's in obstetric clinics at MCH Makkah city 2019 was high. Previous history of GDM, antenatal family history of diabetes, low physical activity, overweight and/or obesity and inadequate dietary diversity were significantly associated with GDM. Routine screening of pregnant women and healthy lifestyle are strongly recommended.

Keywords:
prevalence determinants. Gestational diabetes mellitus pregnant women's

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	American Diabetes Association. (2019). 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2019. Diabetes care, 42(Supplement 1), S13-S28.‏
[2]	Bhatia, M., Mackillop, L. H., Bartlett, K., Loerup, L., Kenworthy, Y., Levy, J. C., ... & Hirst, J. E. (2018). Clinical implications of the NICE 2015 criteria for gestational diabetes mellitus. Journal of clinical medicine, 7(10), 376.‏
[3]	Reece, E. A., Leguizamón, G., & Wiznitzer, A. (2009). Gestational diabetes: the need for a common ground. The Lancet, 373(9677), 1789-1797.‏
[4]	Amin, T. T., Al-Sultan, A. I., & Ali, A. (2008). Overweight and obesity and their relation to dietary habits and socio-demographic characteristics among male primary school children in Al-Hassa, Kingdom of Saudi Arabia. European journal of nutrition, 47(6), 310.‏
[5]	Hod, M., Kapur, A., Sacks, D. A., Hadar, E., Agarwal, M., Di Renzo, G. C., ... & Divakar, H. (2015). The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care#. International Journal of Gynecology & Obstetrics, 131, S173-S211.‏
[6]	International Association of Diabetes and Pregnancy Study Groups Consensus Panel. (2010). International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes care, 33(3), 676-682.‏
[7]	Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018). The pathophysiology of gestational diabetes mellitus. International journal of molecular sciences, 19(11), 3342.‏
[8]	Wendland, E. M., Torloni, M. R., Falavigna, M., Trujillo, J., Dode, M. A., Campos, M. A., ... & Schmidt, M. I. (2012). Gestational diabetes and pregnancy outcomes-a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria. BMC pregnancy and childbirth, 12(1), 23.‏
[9]	Razzaqui, S. M., Babar, N., & Rafiq, S. (2019). Assessing the adherence of obstetricians towards postpartum diabetes screening guidelines: a pre-and post-intervention study at secondary care hospital in Karachi, Pakistan. Journal of the Pakistan Medical Association, 69(11), 1673.‏
[10]	Dabelea, D., Snell-Bergeon, J. K., Hartsfield, C. L., Bischoff, K. J., Hamman, R. F., & McDuffie, R. S. (2005). Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program. Diabetes care, 28(3), 579-584.‏
[11]	Lawrence, J. M., Contreras, R., Chen, W., & Sacks, D. A. (2008). Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999–2005. Diabetes care, 31(5), 899-904.‏
[12]	Mwanri, A. W., Kinabo, J., Ramaiya, K., & Feskens, E. J. (2014). Prevalence of gestational diabetes mellitus in urban and rural Tanzania. Diabetes research and clinical practice, 103(1), 71-78.‏
[13]	Saeedi, N., Baatiah, N., Kouther, F., Badros, R., & Habadi, M. (2020). AN EPIDEMIOLOGICAL DESCRIPTIVE OVERVIEW OF CONGENITAL ANOMALIES DETECTED BY ANTENATAL ULTRASONOGRAPHY IN KING ABDUL-AZIZ MEDICAL CITY, JEDDAH, SAUDI ARABIA.‏
[14]	Al-Rubeaan, K. (2015). National surveillance for type 1, type 2 diabetes and prediabetes among children and adolescents: a population-based study (SAUDI-DM). J Epidemiol Community Health, 69(11), 1045-1051.‏
[15]	Roeckner, J. T., Sanchez-Ramos, L., Jijon-Knupp, R., & Kaunitz, A. M. (2016). Single abnormal value on 3-hour oral glucose tolerance test during pregnancy is associated with adverse maternal and neonatal outcomes: a systematic review and metaanalysis. American Journal of Obstetrics and Gynecology, 215(3), 287-297.‏
[16]	Jang, H. C., Jo, Y. M., Park, G. S., Kim, S. Y., Lee, H. G., Yang, J. H., & Sin, S. M. (2003). Pregnancy outcome in Korean women with gestational diabetes mellitus diagnosed by the Carpenter-Coustan criteria. Diabetes and Metabolism Journal, 28(2), 122-130.‏
[17]	Abdelmola, A. O., Mahfouz, M. S., Gahtani, M. A. M., Mouharrq, Y. J., Hakami, B. H. O., Daak, O. I., ... & Alhazmi, A. A. (2017). Gestational diabetes prevalence and risk factors among pregnant women—Jazan Region, Saudi Arabia. Clinical Diabetology, 6(5), 172-177.‏
[18]	Shang, M., & Lin, L. (2014). IADPSG criteria for diagnosing gestational diabetes mellitus and predicting adverse pregnancy outcomes. Journal of Perinatology, 34(2), 100-104.‏
[19]	Feinstein, J. S. (1993). The relationship between socioeconomic status and health: a review of the literature. The Milbank Quarterly, 279-322.‏
[20]	DeSisto, C. L., Kim, S. Y., & Sharma, A. J. (2014). Peer reviewed: Prevalence estimates of gestational diabetes mellitus in the United States, pregnancy risk assessment monitoring system (prams), 2007–2010. Preventing chronic disease, 11.‏
[21]	Carr, D. B., Utzschneider, K. M., Hull, R. L., Tong, J., Wallace, T. M., Kodama, K., ... & Kahn, S. E. (2006). Gestational diabetes mellitus increases the risk of cardiovascular disease in women with a family history of type 2 diabetes. Diabetes care, 29(9), 2078-2083.‏
[22]	Keshavarz, M., Cheung, N. W., Babaee, G. R., Moghadam, H. K., Ajami, M. E., & Shariati, M. (2005). Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diabetes research and clinical practice, 69(3), 279-286.‏
[23]	Garshasbi, A., Faghihzadeh, S., Naghizadeh, M. M., & Ghavam, M. (2008). Prevalence and risk factors for gestational diabetes mellitus in Tehran. Journal of Family and Reproductive Health, 75-80.‏
[24]	Ferrara, A., Kahn, H. S., Quesenberry, C. P., Riley, C., & Hedderson, M. M. (2004). An increase in the incidence of gestational diabetes mellitus: Northern California, 1991-2000. Obstetrics & Gynecology, 103(3), 526-533.‏
[25]	Seshiah, V., Balaji, V., Balaji, M. S., Paneerselvam, A., Arthi, T., Thamizharasi, M., & Datta, M. (2008). Prevalence of gestational diabetes mellitus in South India (Tamil Nadu): a community based study. JAPI, 56, 329-33.‏
[26]	Zargar, A. H., Sheikh, M. I., Bashir, M. I., Masoodi, S. R., Laway, B. A., Wani, A. I., ... & Dar, F. A. (2004). Prevalence of gestational diabetes mellitus in Kashmiri women from the Indian subcontinent. Diabetes research and clinical practice, 66(2), 139-145.‏
[27]	Verma, A. K., Singh, B., & Mengi, V. (2008). Gestational diabetes in rural women of Jammu. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 33(1), 54.‏
[28]	Mwanri, A. W., Kinabo, J., Ramaiya, K., & Feskens, E. J. (2015). Gestational diabetes mellitus in sub‐Saharan Africa: systematic review and metaregression on prevalence and risk factors. Tropical Medicine & International Health, 20(8), 983-1002.‏
[29]	Nelson, S. M., Matthews, P., & Poston, L. (2010). Maternal metabolism and obesity: modifiable determinants of pregnancy outcome. Human reproduction update, 16(3), 255-275.‏
[30]	Swami, S. R., Mehetre, R., Shivane, V., Bandgar, T. R., Menon, P. S., & Shah, N. S. (2008). Prevalence of carbohydrate intolerance of varying degrees in pregnant females in western India (Maharashtra)--a hospital-based study. Journal of the Indian Medical Association, 106(11), 712-4.‏