Maternal Risk Factors of Gestational Diabetes Mellitus a Case Control Study in a Tertiary Care Setting of Delhi
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Background: Gestational diabetes mellitus (GDM) has been observed to be associated with increased perinatal morbidity and mortality. GDM is becoming a public health concern globally as well as in India with fast increasing trend. It affects approximately 14% of all pregnancies.
Objective: To study the maternal risk factors for developing GDM in pregnant women based on personal and family histories.
Material and Methods: A hospital based case control study was conducted in Lady Hardinge Medical College and associated hospital with a sample size of 104 (52 cases & 52 controls). Pregnant women with gestational diabetes mellitus as diagnosed by abnormal oral Glucose Tolerance Test (OGTT) were taken as cases and pregnant women who have completed 24 weeks of gestation and who tested negative on Glucose Challenge test (GCT) were selected as controls. The data was compiled and analysed in SPSS version 12.
Results: Maternal age 25-30 years vs<25 years, OR=2.27; Maternal age >30 years vs<25 years, OR=7.75; socioeconomic status : upper vs lower OR= 56.25; middle vs lower OR=7.50; working women OR=5.23, age at menarche 13-16 years OR=4.09, > 16 years OR=31.90; irregular menses OR=7.93; Age at conception- 25-30 years vs<25 years >30 years vs<25 years OR= 1.65(0.62-4.37), 7.41(0.85-64.58) respectively; Parity ≥3 vs<3 OR=1.43, Family history of DM OR= 11.07.
Conclusions: The information found in the study regarding the risk factors may contribute heavily to the policy makers to develop strategies to combat the problem of GDM in the community.
- King H, Rewers M. Global estimates for prevalence of diabetes and impaired glucose tolerance in adults.WHO Ad Hoc Diabetes Reporting Group. Diabetes Care1993; 16: 157-177.
- Hanna FW, Peters JR. Screening for gestational diabetes; past, present and future. Diabet Med 2002;19:351–8.
- Lobner K, Knopff A, Baumgarten A, Mollenhauer U, Marienfeld S, Garrido-Franco M, et al. Predictors of postpartum diabetes in women with gestational diabetes mellitus. Diabetes 2006;55:792–7.
- Metzger B E, Coustan D R, Summary and recommendations of the Fourth International Workshop- Conference on Gestational Diabetes Mellitus. Diabetes Care 1998;21:161– 167.
- Mensing C, Boucher J, Cypress M, Weinger K, K Mulcahy, B Patrcia et al. American Diabetes Association. Standards of medical care in diabetes2012. Diabetes Care 2012. 35: S11-S63.
- Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Arthi T, Thamizharasi M, et al. Prevalence of gestational diabetes mellitus in South India(Tamil Nadu) –a community based study. J Asso Physicians India. 2008;56:329-33.
- Dempsey JC, Sorensen TK, Williams MA, Lee IM, Miller RS, Dashow EE et al. Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol 2004; 159:663670.
- Moses RG, Shand JL, Tapsell LC. The recurrence of gestational diabetes: could dietary differences in the fat intake be an explanation? Diabetes care 1997; 20;1647-1650.
- Bhat M, Ramesha KN, Shankara PS, Menon S, Sowmini CV, Kumar GS. Determinants of gestational diabetes mellitus: A case control study in a district tertiary care hospital in South India. Int J DiabDevCtries 2010; 30(2):91-96.
- J. M. Lawrence, R. Contreras, W. Chen, and D. A. Sacks. Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999–2005. Diabetes Care 2008;31(5):899– 904.
- England LJ, Levine RJ, Qian C, Soule LM, Schisterman EF, Yu KF et al. Glucose tolerance and risk of gestational diabetes mellitus in nulliparous women who smoke during pregnancy. Am J Epidemiol 2004;160:1205-1213
- Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet 2009;373:1773–9.
- Kjos SL, Buchanan TA. Gestational diabetes mellitus. N Engl J Med 1999. 341: 1749–1756.
- Damm P, Kuhl C, Bertelsen A, Molsted PI. Predictive factors for the development of diabetes in women with previous gestational diabetes mellitus. Am J ObstetGynecol 1992; 167:607–616.
- Jovanovic L, Pettitt DJ. Gestational diabetes mellitus. JAMA 2001; 286:2516-8.
- Biswas R T. Risk factors and pregnancy outcomes among gestational diabetic mothers: A hospital based study in Bangladesh. [MPhil Research Projects in International Community Health]. University of Oslo. Accessed on www.med.uio.no/ helsam/english/research/groups/...
- Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15(7):539-553.
- Ben Haroush A, Yogev Y, Hod M. Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetes. Diabet Med 2004; 21(2):103113.
- Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clin Invest 2005; 115(3):485-491.
- 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 :728-733.
- Zargar A H, Sheikh M I, Masoodi S R, Laway BA et al. Prevalence of gestational diabetes in Kashmiri women from the Indian sub continent. Diabetes Res. Clin. Pract. 2004;66:139-145
- Nilofer A R, Raju V S, Zaki S A. Screening in highrisk group of gestational diabetes mellitus with its maternal and fetal outcomes. Indian J Endocrinol Metab.2012; 16(7):74-78.
- Bener A, Saleh N M, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int J Women’s Health 2011;3:367-373.
- Kalra P, Kachhwaha C P, Singh H V. Prevalence of gestational diabetes mellitus and its outcome in western Rajasthan. Indian J Endo Metab 2013; 17(4):677-680
- Akwilina W. M, Joyce K, Kaushik R, Edith J.M. F. Prevalence of gestational diabetes mellitus in urban and rural Tanzania. Diabres 2014;103:71-78.
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