A review of gestational diabetes mellitus management, risk factors, maternal and neonatal outcomes in two major maternity hospitals in the United Arab Emirates: A report from Dubai

2020 ◽  
Vol 13 (4) ◽  
pp. 555-562
Author(s):  
Mahera Abdulrahman ◽  
Zainabsadat Tabatabaei ◽  
Sadia Maqbool ◽  
Khadija Hafidh ◽  
Zahra SM Husain ◽  
...  

OBJECTIVES: This study was conducted in order to explore and analyze the status of gestational diabetes (GDM) amongst pregnant women in Dubai, United Arab Emirates (UAE); a country with high prevalence of diabetes. We aimed to describe GDM-associated risk factors and clinical outcomes of pregnant women and their neonates. Our objective was to contribute to the broader literature on reproductive health disparities and to inform efforts to improve GDM care at our region. METHODS: Chart review of case records were used to collect data on both maternal and neonatal parameters and outcomes during the specified study period from two main maternity hospitals in Dubai. RESULTS: UAE national women with GDM were more prone to be obese or overweight compared to non-UAE women (p < 0.0001, and p < 0.0001 respectively). In addition, UAE national women with GDM had higher history of GDM in previous pregnancies (p < 0.0001) and more family history of diabetes (p < 0.0001). The neonate admission into NICU was significantly associated with cesarean section (p < 0.0001), twins (p < 0.0001), preeclampsia (p = 0.02), receiving MgSO4 (p = 0.02), birth weight less than 2500 g (p < 0.0001), low Apgar scores (p < 0.0001), baby with congenital anomaly (p < 0.0001), and neonatal hypoglycemia (p < 0.0001). CONCLUSIONS: Our results demonstrate that pregnant women with GDM who are UAE nationals and have higher parity need to be under special attention during their pregnancy in order to improve both maternal and neonatal outcomes.

2013 ◽  
Vol 5 (1) ◽  
pp. 39-46 ◽  
Author(s):  
JC Nwaokoro ◽  
CO Emerole ◽  
SNO Ibe ◽  
AN Amadi ◽  
INS Dozie

Background Gestational diabetes is emerging as a serious public health problem in Nigeria where the largest number of people with diabetes in Africa occurs. Current studies in Nigeria give an overall prevalence of gestational diabetes as 13.4% among pregnant women with unidentified risk factors. Aims and Objectives This study aimed at investigating the risk factors associated with gestational diabetes. Materials and Methods A cross-section analytical study design was adopted for this research and comprising a total of 100 pregnant women receiving ante-natal health care service at the Federal Medical Center, Owerri. A structured questionnaire including a set of detailed pre-determined questions was administered on the subjects. Data collected were analyzed statistically, using chi-square and T test. Results The results obtained suggest that there is a significant relationship (p<0.05) between previous macrosomic baby, parity, previous history of caesarean section, family history of diabetes and occurrence of gestational diabetes, respectively. However, there is no significant relationship (p>0.05) between history of miscarriages and stillbirth, socioeconomic status and occurrence of gestational diabetes. A family history of diabetes is independently and significantly associated with the development of gestational diabetes itself even after adjusting for other risk factors. Conclusion This study will be a working tool to guide obstetricians and midwives in counseling and advising women of their risk of developing GDM. DOI: http://dx.doi.org/10.3126/ajms.v5i1.8302 Asian Journal of Medical Science Vol.5(1) 2014 pp.39-46  


2017 ◽  
Vol 5 (1-2) ◽  
pp. 49-53
Author(s):  
Zinat Begum ◽  
Dewan Shahida Banu ◽  
Shaila Sharmeen Shanta ◽  
Shitil Ibna Islam

Objective: The present study was undertaken to determine the risk factors for Gestational Diabetes Mellitus (GDM) presented at Bangladesh Institute of Research in Diabetes, Endocrine & Metabolic Disorders (BIRDEM). Materials & methods: The present case-control study was conducted at BIRDEM Hospital, Dhaka over a period of 6 months from July to December 2011. A total of 100 pregnant women (20 cases and 80 controls) were consecutively enrolled in the study. Pregnant women who developed diabetes at their 3rd trimester were cases (n = 20), while pregnant women free from diabetes at their 3rd trimester were controls (n = 80). The diagnosis of GDM was made using a two-step approach. Pregnant women were initially screened by measuring the plasma glucose concentrations 1 hour after a 50 gram of oral glucose challenge. A diagnostic oral glucose tolerance test was performed on the subset of women whose plasma glucose concentrations exceded the threshold value for glucose (> 140 mg/dl). Result: The study showed that older patients (≥ 25 years) were predominant in both case and control groups. The groups were almost comparable in terms of socioeconomic status and occupation. The distribution of gestational age was also similar between groups (33.1 ± 6.3 vs. 34.2 ± 3.9 years, p = 0.476). Majority (85%) of the cases had family history of diabetes (p < 0.001). Thirty five percent of cases were nulipara and 65% multipara compared to 51.3% and 48.7% respectively of the control (p = 0.076). No significant difference was observed between the groups in terms of preterm labour and PROM (p = 0.690 and 0.220 respectively). Forty percent of cases had past history of GDM compared to 3.8% of controls (p < 0.001). The fasting plasma glucose and plasma glucose 2 hrs after 75 g of glucose ingestion were significantly higher in pregnant women having GDM than those in normal pregnant women (8.3 ± 3.1 vs. 4.1 ± 0.5 mmol/L, p < 0.001;12.9 ± 4.8 vs. 5.9 ± 1.2 mmol/L, p < 0.001 respectively). Conclusion: The study concluded that none of the sociodemographic characteristics like age, socioeconomic status and occupation was found to be associated with GDM. However, pregnant women with family history of diabetes are at risk of developing GDM significantly more than those without GDM. Multipara tend to develop GDM more frequently than the primipara does. Past incidence of GDM increases the risk of GDM in the subsequent pregnancy. Ibrahim Card Med J 2015; 5 (1&2): 49-53


2018 ◽  
Vol 5 (3) ◽  
pp. 737 ◽  
Author(s):  
Masaraddi Sanjay K. ◽  
Saranya Andal Kishore ◽  
Nedunchezian P. ◽  
Sulekha C.

Background: Gestational diabetes mellitus (GDM) is amongst the most common medical complications of pregnancy associated with adverse maternal and perinatal outcomes. The prevalence of GDM is increasing worldwide especially in India with increasing obesity and lifestyle and dietary changes. Hence this study was undertaken to study the prevalence of GDM and to evaluate its neonatal outcomes.Methods: This was a prospective study. During the study period, 205 pregnant women between 24 to 28 weeks of gestation were screened for GDM using 75 g oral glucose tolerance test (OGTT) and were diagnosed to have GDM based on WHO criteria. Risk factors for GDM, maternal and neonatal outcomes were studied.Results: The prevalence of GDM in the study population was 7.8%. Prevalence of GDM cases was significantly associated with body mass index (BMI) >25 kg/m2, family history of diabetes, previous macrosomia/large for gestational age (LGA) baby and past history of GDM with p <0.001 and with multiparity (p = 0.024). Maternal age >25 years was not statistically associated with prevalence of GDM (p = 0.358). Incidence of pre-eclampsia and polyhydramnios were significantly higher among GDM cases. Operative delivery and assisted (forceps) delivery had strongly significant association with GDM (p <0.001). GDM cases were significantly associated with higher birth weight (>3.5 kg) in the neonates (p <0.001). Hypoglycemia was the most common complication noted in neonates of GDM women. Incidence of respiratory distress, transient tachypnea of the newborn (TTN), polycythemia and neonatal hyperbilirubinemia were also significantly more common among neonates born to GDM women.Conclusions: BMI >25 kg/m2, family history of diabetes, past GDM and previous LGA baby were important risk factors for GDM. The study emphasizes the need to screen all pregnant women for GDM, so that timely diagnosis and intervention will reduce both maternal and perinatal complications.


Author(s):  
Małgorzata Lewandowska

Whether categories of family history of diabetes can act as independent risk factors for gestational diabetes mellitus (GDM-1, -2) has not yet been established, and neither has it been established how categories of body mass index (BMI) affect these relationships. A group of 912 women without chronic diseases, recruited in the first trimester, was investigated: 125 (13.7%) women developed GDM-1 (treated with diet); 21 (2.3%) women developed GDM-2 (treated with insulin); and a control group consisted of 766 non-diabetic women. A multiple logistic regression was used to evaluate adjusted odds ratios (AOR (95% confidence intervals)) of GDM-1 and GDM-2 for declared diabetes in the parents or grandparents (separately). These relationships were investigated in the whole cohort and subgroups of pre-pregnancy BMI. (1) Some categories of the family history were independent risk factors of GDM-1 or GDM-2. Compared to ‘absence of diabetes in the family’, women with diabetes in the father had a 3.68-fold increase in GDM-1 risk (AOR-b = 3.68 (2.23–6.07)), and women with diabetes in the mother had a 2.13-fold increase in GDM-1 risk (AOR-b = 2.13 (1.1−4.14)) and a 4.73-fold increase in GDM-2 risk (AOR-b = 4.73 (1.26−17.77)). Women with diabetes in the grandmother had a 2.34-fold increase in GDM-1 risk (AOR-b = 2.34 (1.29−4.24)). (2) The cumulative assessment of diabetes in the parents and/or grandparents was not related to the intensification of the risk of GDM, except for the increased risk of GDM-1 for diabetes in both mother and grandmothers simultaneously (AOR-b = 8.80 (1.16−66.57)), however, this group was very small. (3) The analyses in the subgroups of BMI categories showed that diabetes in the father was also an independent risk factor of GDM in the subgroup of pregnant women with normal BMI. In the subgroups of overweight and/or obesity, the risk of GDM for paternal and maternal diabetes was approximately twice as high as compared to the results of pregnant women with normal BMIs. Additionally, apart from the maternal influence of diabetes, the results suggest a significant influence of diabetes in the father on the risk of GDM, even (interestingly) in lean pregnant women.


2020 ◽  
Vol 9 ◽  
pp. 1642
Author(s):  
Mina Etminan-Baksh ◽  
Sima Tadi ◽  
Monireh Hatami ◽  
Roksana Darabi

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] DOI:10.31661/gmj.v9i0.1642 


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hayfaa Wahabi

Objectives. The objective of this study was to determine the incidence and risk factors of glucose intolerance one year after delivery in women with gestational diabetes (GDM). Methods. All women who had GDM and completed one year since delivery at King Khalid University Hospital were contacted to participate in the study. Based on to the American Diabetes Association criteria and the results of fasting blood glucose (FPG) and HbA1c, participants were classified into three groups: diabetic, impaired glucose tolerance (IGT), and normal. The incidence of diabetes and IGT was calculated. Clinical, biochemical, and sociodemographic predictors of glucose intolerance were compared between the three groups. Odds ratio (OR) for risk factors with P value less than 0.05 was calculated. Results. From a total 316 eligible women, 133 fulfilled the inclusion criteria and agreed to participate in the study. From the study participants, 58 (44%) women were normoglycemic, 60 (45%) women had IGT, and 15 (11%) women were diabetic. The odds of developing IGT or diabetes increased to nearly fourfold when women needed insulin for the control of GDM during pregnancy (OR 3.8, 95% CI 0.81–18.3, P=0.08) and to nearly one-and-a-half-fold when they have positive family history of T2DM (OR 1.2, 95% CI 0.74–2.09, P=0.40). Nevertheless, none of the odds ratios was statistically significant. Conclusion. The incidence of postpartum hyperglycemia (diabetes and IGT) is very high in Saudi women with GDM. Family history of diabetes and insulin treatment of GDM may be predictors of postpartum hyperglycemia.


Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.

Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.


2017 ◽  
Vol 41 (S1) ◽  
pp. S419-S419
Author(s):  
G. Chorwe-Sungani ◽  
J. Chipps

IntroductionDepression is one of major health problems affecting pregnant women in low resource settings. It can lead to poor uptake of antenatal services. Data about prevalence of antenatal depression and associated risk factors remain scanty in Malawi. The study settings were eight selected antenatal clinics in Blantyre district, Malawi. The aim of this study was to assess prevalence of antenatal depression and associated risk factors among pregnant women attending antenatal clinics in Blantyre district, Malawi.MethodsThis was a quantitative study which used a random sample of 97 pregnant women. Ethical approval was granted by relevant bodies. Descriptive and inferential statistics were used to analyse data.ResultsPrevalence of antenatal depression in Blantyre district was 25.8% (n = 25). Risk factors associated with antenatal depression included: “being distressed by anxiety or depression for more than two weeks during this pregnancy”; “feeling that pregnancy has been a positive experience”; “having a history of feeling miserable or depressed for two weeks or more before this pregnancy”; “relationship with partner is an emotionally supportive one”; “experiencing major stresses, changes or losses in the course of this pregnancy”; “having history of physical abuse when growing up”, and “having concerns about being or becoming a mother”.ConclusionThis study has shown that antenatal depression is prevalent in Malawi. It suggests that psychosocial interventions targeting pregnant women may be necessary to reduce antenatal depression and associated risk factors. However, further research regarding ways for assisting pregnant women to build and strengthen their psychosocial support structures is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Vol 6 (6) ◽  
pp. 155-160
Author(s):  
Salomon Philippe Nguwoh

Background: In Republic of Chad, the seroprevalence of HIV among antenatal pregnant women is known as decreasing over years meanwhile the epidemiological data among pregnant women for hepatitis B virus are scarce. The co-infection HIV/HBV increases the risk of mother to child transmission of both viruses. This study aimed to determine the rate of HIV, HBV co-infection and to identify the associated risk factors among pregnant women attending Guelendeng health district (GHD). Methods: A cross-sectional and descriptive study was conducted from March to May 2019 among pregnant women attending GHD. The questionnaire included demographics, AIDS and HBV knowledge, behavior factors and history of blood transfusion. Blood samples were obtained and tested serologically for HIV and HBV. The study of associations between exposure and outcome variables was sought with the odds ratio (OR), expressed with 95% confidence interval. Tests were performed using Epi info 7.0 with p<0.05 considered as significant. Results: Out of 200 enrolled pregnant women, the median age was 25years old with interquartile range from 20.5 to 30 years old. The seroprevalence of HIV, HBV and the co-infection HIV/HBV were 4.5% (95% CI: 2.1%-8.4%; 9/200), 13% (95% CI: 8.7%-18.5%; 26/200) and 2% (95 % IC: 0.6%-5%; 4/200) respectively. The antenatal age was associated to HBV infection (p=0.04) unlike HIV infection (p=0.4) and HIV/HBV co-infection (p=0.52). Women aged more than 29 years were most affected. Bivariate analysis identified that the non-use of condom (OR 7.79, 95% CI: 1.9-32.6, p=0.004) and blood transfusion history (OR 17.9, 95% CI: 2.6-124.8, p=0.01) were associated risk factors of contracting HIV. Conclusion: The seroprevalence of HIV and HBV remains high among pregnant women attending antenatal ward in Guelendeng Health District with associated risk factors such as age, blood transfusion and the non-use of condom with new sexual partners.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255189
Author(s):  
Muhammad Israr ◽  
Fawad Ali ◽  
Arif Nawaz ◽  
Muhammad Idrees ◽  
Aishma Khattak ◽  
...  

Background & aim Hepatitis B and C infections are global issues that are associated with a massive financial burden in developing countries where vertical transmission is the major mode and remains high. This cross-sectional study was designed to investigate the seroepidemiology and associated risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among 375 pregnant women attending antenatal care health facilities at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi, Khyber Pakhtunkhwa, Pakistan. Methodology From a total of 375 pregnant women selected using systematic random sampling from both hospitals, 10 ml of blood samples were collected and alienated serum was examined for indicators identification through the Immuno-Chromatographic Test (ICT) and 3rd Generation Enzyme-Linked Immunosorbent Assay (ELISA). A pre-structured questionnaire was used to collect the socio-demographic data and possible risk factors. The data was analyzed via SPSS 23.0 statistical software. A chi-square analysis was performed to determine the association between variables. P-value < 0.05 was set statistically significant. Results The overall frequency of HBV and HCV among 375 pregnant women involved in the study was 3.7% and 2.1% respectively. None of the pregnant women were co-infected with HBV and HCV. Dental extraction (P = 0.001) and blood transfusion (P = 0.0005) were significantly allied with HBV infection while surgical procedure (P = 0.0001) was significantly associated with HCV infection. Moreover the sociodemographic characteristics: residential status (P = 0.017) and educational level (P = 0.048) were found significant risk factors of HBsAg and maternal age (P = 0.033) of anti-HCV, respectively. Conclusion & recommendation HBV and HCV infections are intermediary endemic in the study area. A higher prevalence of HBV was detected among pregnant mothers with a history of dental extraction, history of blood transfusion, resident to the urban area and low educational level. The age and surgical procedures were the potential risk factors found significantly associated with HCV positivity among pregnant mothers in our setup. Future negotiations to control vertical transmission should include routine antenatal screening for these infections early in pregnancy and the requirement of efficient preventive tools including the birth dose of the hepatitis B vaccine in combination with hepatitis B immune globulins to the neonate.


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