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Veerasetty NK, Venkatachalam J, Subbaiah M, Arikrishnan K, Soni B. Determinants of health literacy and its impact on glycemic control among women with gestational diabetes mellitus in a tertiary care hospital, Puducherry - A cross-sectional analytical study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:119. [PMID: 38726069 PMCID: PMC11081463 DOI: 10.4103/jehp.jehp_762_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/05/2023] [Indexed: 05/12/2024]
Abstract
BACKGROUND Health literacy is vital during pregnancy, as maternal health knowledge and behavior have a significant impact on the health of both mother and child. Hence, this study aimed to assess the health literacy status of pregnant women diagnosed with gestational diabetes mellitus (GDM), as well as its associated factors and impact on glycemic control. MATERIALS AND METHODS The facility-based Cross-sectional analytical study was conducted among 200 pregnant women with GDM in a tertiary care hospital. The eligible participants were consecutively selected for the study. The study was conducted from September 2022 to March 2023. A validated semi-structured questionnaire, the Health Literacy Questionnaire (HLQ) for GDM, was used to measure health literacy status. Stata V.17 software was used for data analysis. RESULTS Out of 200 pregnant women with GDM, the mean (SD) age of the participants is 29.5 (±5.5) years. It was observed that 164 (82%) of the participants had adequate health literacy, whereas 36 (18%) had inadequate health literacy about Gestational Diabetes. Adequate health literacy (HL) was observed among 88.5% of women with controlled blood sugar and 55.1% of women with uncontrolled blood sugar. Results of multivariate logistic regression analysis revealed that pregnant mothers' educational status (PR: 1.8; 95% CI: 1.2-2.5) and glycemic control (PR: 1.4; 95% CI (1.2-1.7) were associated with adequate HL. CONCLUSIONS In conclusion, this study supports the association between adequate HL and glycemic control in pregnant women with GDM. Addressing this gap is essential for healthcare officials and planners to implement programs that promote women's HL during pregnancy, with a focus on low-educated groups.
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Affiliation(s)
| | - J. Venkatachalam
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
| | - Murali Subbaiah
- Department of Obstetrics and Gynecology, JIPMER, Puducherry, India
| | | | - Bhanushree Soni
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
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Mantri N, Goel AD, Patel M, Baskaran P, Dutta G, Gupta MK, Yadav V, Mittal M, Shekhar S, Bhardwaj P. National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis. BMC Public Health 2024; 24:527. [PMID: 38378536 PMCID: PMC10877914 DOI: 10.1186/s12889-024-18024-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/06/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is frequently misdiagnosed during pregnancy. There is an abundance of evidence, but little is known regarding the regional prevalence estimates of GDM in India. This systematic review and meta-analysis aims to provide valuable insights into the national and regional prevalence of GDM among pregnant women in India. METHODS We conducted an initial article search on PubMed, Scopus, Google Scholar, and ShodhGanga searches to identify quantitative research papers (database inception till 15th June,2022). This review included prevalence studies that estimated the occurrence of GDM across different states in India. RESULTS Two independent reviewers completed the screening of 2393 articles, resulting in the identification of 110 articles that met the inclusion criteria, which collectively provided 117 prevalence estimates. Using a pooled estimate calculation (with an Inverse square heterogeneity model), the pooled prevalence of GDM in pregnant women was estimated to be 13%, with a 95% confidence interval (CI) ranging from 9 to 16%.. In India, Diabetes in Pregnancy Study of India (DIPSI) was the most common diagnostic criteria used, followed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) and World Health Organization (WHO) 1999. It was observed that the rural population has slightly less prevalence of GDM at 10.0% [6.0-13.0%, I2=96%] when compared to the urban population where the prevalence of GDM was 12.0% [9.0-16.0%, I2 = 99%]. CONCLUSIONS This review emphasizes the lack of consensus in screening and diagnosing gestational diabetes mellitus (GDM), leading to varied prevalence rates across Indian states. It thoroughly examines the controversies regarding GDM screening by analyzing population characteristics, geographic variations, diagnostic criteria agreement, screening timing, fasting vs. non-fasting approaches, cost-effectiveness, and feasibility, offering valuable recommendations for policy makers. By fostering the implementation of state-wise screening programs, it can contribute to improving maternal and neonatal outcomes and promoting healthier pregnancies across the country.
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Affiliation(s)
- Neha Mantri
- School of Public Health, AIIMS, Jodhpur, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India.
| | - Mamta Patel
- School of Public Health, AIIMS, Jodhpur, India
| | - Pritish Baskaran
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | - Gitashree Dutta
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | - Manoj Kumar Gupta
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | | | - Madhukar Mittal
- Department of Endocrinology and Metabolism, AIIMS, Jodhpur, India
| | | | - Pankaj Bhardwaj
- Department of Community Medicine & Family Medicine, Academic Head, School of Public Health, AIIMS, Jodhpur, India
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Basu J, Mukherjee R, Sahu P, Datta C, Chowdhury S, Mandal D, Ghosh A. Association of common variants of TCF7L2 and PCSK2 with gestational diabetes mellitus in West Bengal, India. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2023; 43:185-202. [PMID: 37610142 DOI: 10.1080/15257770.2023.2248201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023]
Abstract
The genetic etiology of gestational diabetes mellitus (GDM) was suggested to overlap with type-2 diabetes(T2D). Transcription factor 7-like 2 (TCF7L2) and Proprotein Convertase Subtilisin/Kexin type 2 (PCSK2) are T2D susceptibility genes of the insulin synthesis/processing pathway. We analyzed associations of TCF7L2 and PCSK2 variants with GDM risk and evaluated their potential impact on impaired insulin processing in an eastern Indian population. The study included 114 GDM (case) and 228 non-GDM pregnant women (control). rs7903146, rs4132670, rs12255372 of TCF7L2, and rs2269023 of PCSK2 were genotyped by PCR-RFLP, and genotype distributions were compared between case and control. Fasting serum proinsulin and C-peptide levels were measured by ELISA and the Proinsulin/C-peptide ratio was considered an indicator of proinsulin conversion. Significantly higher frequency of risk allele (T) of rs12255372 (p = 0.02, OR = 2.0, 95%CI = 1.11-3.64) and rs4132670 (p = 0.002, OR = 2.26, 95%CI = 1.32-3.87) of TCF7L2 was found in GDM cases than non-GDM controls; TT genotype was associated with significantly increased disease risk. In rs7903146 (TCF7L2) and rs2269023 (PCSK2), although the frequency of risk allele (T) was not significantly higher in cases than controls, an association of TT for both variants remained significant with higher GDM risk in the recessive model. Increased serum pro-insulin and proinsulin:c-peptide ratio was found in GDM than non-GDM women and the phenomenon showed significant association with careers of risk alleles for TCF7L2 variants. In conclusion, TCF7L2 and PCSK2 variants are related to GDM risk in the studied population and hence may serve as potential biomarkers for assessing the disease risk. TCF7L2 variants contribute to impaired insulin processing.
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Affiliation(s)
- Jayita Basu
- Department of Life Sciences, Presidency University, Kolkata, India
| | | | - Pooja Sahu
- Department of Gynecology and Obstetrics, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Chhanda Datta
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Subhankar Chowdhury
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Debasmita Mandal
- Department of Gynecology and Obstetrics, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Amlan Ghosh
- Department of Life Sciences, Presidency University, Kolkata, India
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Gautam PK, Agarwal M, Agarwal A, Singh VK, Jauhari S. Gestational glucose intolerance (GGI) and gestational diabetes mellitus (GDM) among antenatal women attending urban community health centers of Lucknow: A cross-sectional study. J Family Med Prim Care 2023; 12:611-618. [PMID: 37312767 PMCID: PMC10259573 DOI: 10.4103/jfmpc.jfmpc_1134_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/07/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) is an emerging public health concern in India, which has detrimental effects on both the mother and the baby. The data on prevalence of GDM was unavailable at secondary urban health facilities, from where a majority of pregnant women seek antenatal services, and the following study identifies this burden. Methods A cross-sectional study was conducted from May 2019 to June 2020 among pregnant women attending the antenatal outpatient department (OPD) at secondary level health facilities in urban Lucknow. A semi-structured interview schedule was administered to the study subjects for collecting the relevant information and 75 g of oral glucose tolerance test was performed irrespective of the meal. The cut-off points taken for the diagnosis of GDM and gestational glucose intolerance (GGI) was as per the guidelines of the Ministry of Health and Family Welfare for diagnosis of GGI/GDM. Results The overall prevalence of GDM and GGI in the study was 11.6% and 16.8%, respectively. Three-fourth of the women (22/29) were diagnosed with GDM in the second trimester of pregnancy. The prevalence of GDM (16.7%) was significantly higher in pregnant women aged more than 25 years and in those who were overweight. Mean birth weight (3.2 ± 8.1 kg) of the babies was significantly higher in the women with GDM. Among the fetal complications was respiratory distress observed among 28 pregnant women and 31% of them had GDM and this was statistically significant. Conclusion The prevalence of GGI and GDM was found 16.8% and 11.6%, respectively. Gestational age, pre-pregnancy weight, pre-pregnancy BMI, weight gain during the pregnancy, family history of diabetes. PCOS, macrosomia and GDM in prior pregnancies was found to significant with GDM in the study.
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Affiliation(s)
- Pradeep K. Gautam
- Department of Community Medicine, Autonomous State Medical College, Hardoi, Uttar Pradesh, India
| | - Monika Agarwal
- Department of Community Medicine and Public Health, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Anjoo Agarwal
- Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - V. K. Singh
- Department of Community Medicine and Public Health, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Sugandha Jauhari
- Department of Community Medicine and Public Health, King George Medical University, Lucknow, Uttar Pradesh, India
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Abd Latif R, Yusof NA, Yahya R, Muda Z, Tengku Lih TB, Mohamed K, Lah D, Abd Kadir R, Hassan M, Wan Sulaiman WR, Akbar Merican SA, Mohd Hanafi MSI. The prevalence of gestational diabetes, associated factors and feto-maternal outcome among antenatal women attending health clinics in Terengganu. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2022; 17:43-52. [PMID: 36606162 PMCID: PMC9809446 DOI: 10.51866/oal302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a known risk factor for diabetes mellitus (DM). The rising prevalence of GDM in the Asian population (11.7%) may explain the increasing incidence of DM in women. This study examined the prevalence of GDM, its associated factors and the foeto-maternal outcomes of women with GDM in Terengganu. METHOD A cross-sectional study was conducted between April and September 2019 using secondary data from antenatal records in 40 health clinics in Terengganu for 2018. All pregnant women aged 25 years and above with or without risk factors for GDM were included in the study. Those with pre-existing type 1 or 2 DM were excluded. A total of 270 respondents were included. The prevalence of GDM and its associated factors were determined using descriptive statistics followed by multiple logistic regression. RESULTS The prevalence of GDM in Terengganu was 27.3% (n=72). Logistic regression analysis found that BMI at booking (adjusted OR=4.51, 95% CI 2.13-9.55, p<0.001), history of GDM (adjusted OR=5.31, 95% CI 2.17-12.99, p<0.001) and family history of DM (adjusted OR=4.24, 95% CI 2.23-8.05, p<0.001) were the significant associated risk factors. Of women with GDM, 17.7% (n=11) had postpartum pre-diabetes based on modified oral glucose tolerance at 6 weeks postpartum. Univariate analysis using chi-square tests showed a significant association of neonatal jaundice and hypoglycaemia with GDM. CONCLUSION Because the prevalence of GDM in Terengganu is high, surveillance of GDM in highrisk pregnancies and effective glycaemic management should be emphasised to prevent adverse foeto-maternal outcomes.
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Affiliation(s)
- Rozimah Abd Latif
- MMBS (Adelaide), MMed (Family Medicine) USM, Klinik Kesihatan Merchang, Marang, Terengganu, Malaysia
| | - Nurul Azreen Yusof
- MD (UKM), MMed (Family Medicine) USM, Faculty of Medicine, Universiti Sultan, Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia.
| | - Ranimah Yahya
- MD (UKM), MMed (Family Medicine) USM, Klinik Kesihatan Rahmat, Chalok, Setiu, Terengganu, Malaysia
| | - Zahrni Muda
- MD (USM), MMed (Family Medicine) USM, Klinik Kesihatan Al-Muktafi Billah, Shah, Jengai, Dungun, Terengganu, Malaysia
| | - Tengku Bahiah Tengku Lih
- MD (UKM), MMed (Family Medicine) UKM, Klinik Kesihatan Padang Luas, Jerteh, Besut, Terengganu, Malaysia
| | - Kamilah Mohamed
- MD (UKM), MMed (Family Medicine) UKM, Klinik Kesihatan Batu Rakit, Kuala, Nerus, Terengganu, Malaysia
| | - Darisah Lah
- MD (UKM), MMed (Family Medicine), UKM, Klinik Kesihatan Bukit Tunggal, Kuala, Nerus, Terengganu, Malaysia
| | - Rohaiza Abd Kadir
- MD (UKM), MMed (Family Medicine) UKM, Klinik Kesihatan Seberang Takir, Kuala Nerus, Terengganu, Malaysia
| | - Maira Hassan
- MBBS (Banglaore), MMed (Family Medicine) USM, Klinik Kesihatan Manir, Kuala, Terengganu, Terengganu, Malaysia
| | - Wan Ruzilasalwa Wan Sulaiman
- MD (UKM), MMed (Family Medicine) UKM, Klinik Kesihatan Kuala, Dungun, Kg Alor Tembese, Kuala Dungun, Dungun, Terengganu, Malaysia
| | - Siti Aminah Akbar Merican
- MD (USM), MMed (Family Medicine) UKM, Klinik Kesihatan Kuala, Berang, Kuala Berang, Terengganu, Malaysia
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Ye W, Luo C, Huang J, Li C, Liu Z, Liu F. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ 2022; 377:e067946. [PMID: 35613728 PMCID: PMC9131781 DOI: 10.1136/bmj-2021-067946] [Citation(s) in RCA: 132] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the association between gestational diabetes mellitus and adverse outcomes of pregnancy after adjustment for at least minimal confounding factors. DESIGN Systematic review and meta-analysis. DATA SOURCES Web of Science, PubMed, Medline, and Cochrane Database of Systematic Reviews, from 1 January 1990 to 1 November 2021. REVIEW METHODS Cohort studies and control arms of trials reporting complications of pregnancy in women with gestational diabetes mellitus were eligible for inclusion. Based on the use of insulin, studies were divided into three subgroups: no insulin use (patients never used insulin during the course of the disease), insulin use (different proportions of patients were treated with insulin), and insulin use not reported. Subgroup analyses were performed based on the status of the country (developed or developing), quality of the study, diagnostic criteria, and screening method. Meta-regression models were applied based on the proportion of patients who had received insulin. RESULTS 156 studies with 7 506 061 pregnancies were included, and 50 (32.1%) showed a low or medium risk of bias. In studies with no insulin use, when adjusted for confounders, women with gestational diabetes mellitus had increased odds of caesarean section (odds ratio 1.16, 95% confidence interval 1.03 to 1.32), preterm delivery (1.51, 1.26 to 1.80), low one minute Apgar score (1.43, 1.01 to 2.03), macrosomia (1.70, 1.23 to 2.36), and infant born large for gestational age (1.57, 1.25 to 1.97). In studies with insulin use, when adjusted for confounders, the odds of having an infant large for gestational age (odds ratio 1.61, 1.09 to 2.37), or with respiratory distress syndrome (1.57, 1.19 to 2.08) or neonatal jaundice (1.28, 1.02 to 1.62), or requiring admission to the neonatal intensive care unit (2.29, 1.59 to 3.31), were higher in women with gestational diabetes mellitus than in those without diabetes. No clear evidence was found for differences in the odds of instrumental delivery, shoulder dystocia, postpartum haemorrhage, stillbirth, neonatal death, low five minute Apgar score, low birth weight, and small for gestational age between women with and without gestational diabetes mellitus after adjusting for confounders. Country status, adjustment for body mass index, and screening methods significantly contributed to heterogeneity between studies for several adverse outcomes of pregnancy. CONCLUSIONS When adjusted for confounders, gestational diabetes mellitus was significantly associated with pregnancy complications. The findings contribute to a more comprehensive understanding of the adverse outcomes of pregnancy related to gestational diabetes mellitus. Future primary studies should routinely consider adjusting for a more complete set of prognostic factors. REVIEW REGISTRATION PROSPERO CRD42021265837.
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Affiliation(s)
- Wenrui Ye
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
| | - Cong Luo
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jing Huang
- National Clinical Research Centre for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chenglong Li
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhixiong Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
| | - Fangkun Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
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Fagninou A, Nekoua MP, Fiogbe SEM, Moutaïrou K, Yessoufou A. Predictive Value of Immune Cells in the Risk of Gestational Diabetes Mellitus: A Pilot Study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:819164. [PMID: 36992781 PMCID: PMC10012146 DOI: 10.3389/fcdhc.2022.819164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/06/2022] [Indexed: 01/04/2023]
Abstract
AimsImmunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here, we assessed the predictive power of immune cells correlated with biochemical parameters in gestational diabetes mellitus (GDM).Materials and MethodsImmune cells and serum biochemical parameters were determined in women with GDM and pregnant controls. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of ratios of immune cells to biochemical parameters for predicting GDM.ResultsBlood glucose, total cholesterol, LDL-cholesterol and triglycerides were significantly increased whereas HDL-cholesterol decreased in women with GDM compared to pregnant controls. Glycated hemoglobin, creatinine, transaminase activities did not significantly differ between both groups. Total leukocyte, lymphocyte and platelet numbers were significantly high in women with GDM. Correlation tests showed that ratios of lymphocyte/HDL-C, monocyte/HDL-C and granulocyte/HDL-C were significantly higher in women with GDM than in pregnant controls (p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte/HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p=0.041).ConclusionOur study showed that ratios of lymphocyte, monocyte and granulocyte to HDL-C might represent valuable biomarkers for GDM and in particular, lymphocyte/HDL-C ratio exhibited a strong predictive power for GDM risk.
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Affiliation(s)
- Adnette Fagninou
- Laboratory of Cell Biology, Physiology and Immunology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST), Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi (UAC), Cotonou, Benin
- Unité de Recherche sur les Maladies Non Transmissibles et le Cancer (UR-MNTC), Laboratory of Research in Applied Biology (LARBA), Ecole Polytechnique d’Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Magloire Pandoua Nekoua
- Laboratory of Cell Biology, Physiology and Immunology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST), Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi (UAC), Cotonou, Benin
| | - Salomon Ezéchiel M. Fiogbe
- Unité de Recherche sur les Maladies Non Transmissibles et le Cancer (UR-MNTC), Laboratory of Research in Applied Biology (LARBA), Ecole Polytechnique d’Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Kabirou Moutaïrou
- Laboratory of Cell Biology, Physiology and Immunology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST), Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi (UAC), Cotonou, Benin
| | - Akadiri Yessoufou
- Laboratory of Cell Biology, Physiology and Immunology, Department of Biochemistry and Cellular Biology, Faculty of Sciences and Technology (FAST), Institute of Applied Biomedical Sciences (ISBA), University of Abomey-Calavi (UAC), Cotonou, Benin
- *Correspondence: Akadiri Yessoufou,
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Shah C, Vaishnav S, Mankad S, Sharma T, Sapre S, Raithatha N, Patel M, Mannari J. Silent upsurge of gestational diabetes: Are we aware? A rural tertiary care experience of Central Gujarat. J Family Med Prim Care 2022; 11:1019-1025. [PMID: 35495827 PMCID: PMC9051691 DOI: 10.4103/jfmpc.jfmpc_1059_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/12/2021] [Accepted: 10/19/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Subjects and Methods: Results: Conclusion:
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9
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Lemieux P, Benham JL, Donovan LE, Moledina N, Pylypjuk C, Yamamoto JM. The association between gestational diabetes and stillbirth: a systematic review and meta-analysis. Diabetologia 2022; 65:37-54. [PMID: 34676425 DOI: 10.1007/s00125-021-05579-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/21/2021] [Indexed: 12/16/2022]
Abstract
AIMS/HYPOTHESIS Controversy exists over whether gestational diabetes increases the risk of stillbirth. The aim of this review was to examine the association between gestational diabetes and stillbirth. METHODS We performed searches of the published literature to May 2021. Study selection and data extraction were performed in duplicate by independent reviewers. Meta-analyses of summary measures were conducted using random-effect models for cohort and case-control studies separately. The study protocol was registered in PROSPERO (registration ID CRD42020166939). RESULTS From 9981 citations, 419 were identified for full-text review and 73 met inclusion criteria (n = 70,292,090). There was no significant association between gestational diabetes and stillbirth in cohort studies (pooled OR 1.04 [95% CI 0.90, 1.21]; I2 86.1%) or in case-control studies (pooled OR 1.57 [95% CI 0.83, 2.98]; I2 94.8%). Gestational diabetes was associated with lower odds of stillbirth among cohort studies presenting with an adjusted OR (pooled OR 0.78 [95% CI 0.68, 0.88]; I2 42.7%). Stratified analyses by stillbirth ≥28 weeks' gestation, studies published prior to 2013 and studies identified as low quality demonstrated a significantly higher odds of stillbirth in meta-regression (p = 0.016, 0.023 and 0.005, respectively). Egger's test for all included cohort studies (p = 0.018) suggests publication bias for the main meta-analysis. CONCLUSIONS/INTERPRETATION Given the substantial heterogeneity across studies, there are insufficient data to define the relationship between stillbirth and gestational diabetes adequately. In the main analyes, gestational diabetes was not associated with an increased risk of stillbirth. However, heterogeneity across studies means this finding should be interpreted cautiously.
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Affiliation(s)
- Patricia Lemieux
- Department of Medicine, CHU de Québec - University Laval, Quebec City, QC, Canada
| | - Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lois E Donovan
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Nadia Moledina
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christy Pylypjuk
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer M Yamamoto
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada.
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
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Rafat D, Singh S, Nawab T, Khan F, Khan AU, Khalid S. Association of vaginal dysbiosis and gestational diabetes mellitus with adverse perinatal outcomes. Int J Gynaecol Obstet 2021; 158:70-78. [PMID: 34561861 DOI: 10.1002/ijgo.13945] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/02/2021] [Accepted: 09/23/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes and is an independent risk factor for vaginal dysbiosis. Understanding the vaginal microbiota in health and disease is essential to screen, detect, and manage complications of pregnancy. Therefore, the aims of the present study were to assess and compare vaginal dysbiosis in pregnancy in women with and without GDM and examine its impact on perinatal outcomes in our population. METHODS The present study was a prospective cohort study recruiting pregnant women. The subjects were divided into two groups (GDM and non-GDM) and were followed until delivery to assess fetomaternal outcomes. Vaginal samples were collected at 24-28 weeks and 34-38 weeks for Nugent scoring and determination of bacterial and fungal species. RESULTS The study recruited 502 pregnant women, with a final assessment of 320 mother-infant pairs (GDM n = 134; non-GDM n = 186). We found a significant association of vaginal dysbiosis with GDM and adverse perinatal outcomes. Significant differences were also seen in status of infection and its trimester-wise changes in relation to hyperglycemia. CONCLUSION By defining an association of vaginal dysbiosis with GDM and its correlation with perinatal outcomes, the present study calls for exploitation of this potential association as a new target in the prevention and treatment of GDM and in alleviating their undesired maternal and infant outcomes.
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Affiliation(s)
- Dalia Rafat
- Department of Obstetrics & Gynaecology, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Sunita Singh
- Department of Obstetrics & Gynaecology, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Tabassum Nawab
- Department of Community Medicine, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Fatima Khan
- Department of Microbiology, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Asad U Khan
- Interdisciplinary Biotechnology Unit, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Shamsi Khalid
- Interdisciplinary Biotechnology Unit, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Gupta S, Gupte S, Gupta S, Bamrah P, Gupta K. Evaluation of treatment strategies and pregnancy outcome among GDM twin versus GDM singleton pregnancy. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00990-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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12
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Hussain T, Das S, Parveen F, Samanta P, Bal M, Yadav VS, Pati S. Prevalence, risk factors and morbidities of gestational diabetes among pregnant women attending a hospital in an urban area of Bhubaneswar, Odisha. J Family Med Prim Care 2021; 9:5327-5333. [PMID: 33409210 PMCID: PMC7773065 DOI: 10.4103/jfmpc.jfmpc_869_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/14/2020] [Accepted: 07/28/2020] [Indexed: 11/04/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) causes several maternal and neonatal complications. Aims This exploratory study was conducted to estimate the prevalence, determine the risk factors and morbidities among pregnant women. Methods In this prospective study, 1557 pregnant women attending the Gyn. & Obs. clinic of a hospital in an urban area of Bhubaneswar were enrolled. Various socio-demographic factors and clinical profiles were assessed. We used a Glucometer for the diagnosis of GDM. Results More younger pregnant women residing in slums, sedentary and overweight were having diabetes. A large percentage of pregnant women living in rural areas and slums visit the government hospitals as they are benefitted by the State govt.'s scheme, Mamata. Pregnant women residing in the urban areas prefer to go for ante-natal check-ups in private Nursing homes/Clinics owing to the crowd and prolonged waiting hours. In this study, body mass index (BMI) and family history of the pregnant women appeared to be the significant risk factors for the gestational diabetes. Out of 1557 pregnant women, 154 were having diabetes, the prevalence being 9.89%. This is low when compared to the studies reported from other regions of the country. Conclusions Gluco-One is suitable for screening gestational diabetes using the optimal threshold capillary glucose level of 140 mg/dl. As the pregnant women find it difficult to come the next day just to collect the results, this facilitated in getting the test results promptly and appropriate consultation by Doctor the same day. Glucometer can be used for accurate screening of gestational diabetes mellitus. Pregnant women with screening values not normal were identified on the spot and followed up at regular intervals. Screening for diabetes among pregnant women would result in early case detection indirectly resulting in better outcomes of treatment and prevention of complications.
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Affiliation(s)
- Tahziba Hussain
- Division of NCDs, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Shritam Das
- Division of NCDs, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Firdoush Parveen
- Division of NCDs, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Prashanti Samanta
- Division of NCDs, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Madhusmita Bal
- Division of NCDs, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - V S Yadav
- Division of NCDs, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Sanghamitra Pati
- Division of NCDs, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
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Mishra S, Shetty A, Rao CR, Nayak S, Kamath A. Risk factors for gestational diabetes mellitus: A prospective case-control study from coastal Karnataka. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Deepa R, Lewis MG, Van Schayck OCP, Babu GR. Food habits in pregnancy and its association with gestational diabetes mellitus: results from a prospective cohort study in public hospitals of urban India. BMC Nutr 2020; 6:63. [PMID: 33292687 PMCID: PMC7677816 DOI: 10.1186/s40795-020-00388-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 10/12/2020] [Indexed: 12/15/2022] Open
Abstract
Background Few studies have explored the relationship between food habits and the risk of gestational diabetes mellitus (GDM) in women from India. We aimed to investigate the associations of food habits and the risk of GDM. Methods As part of the MAASTHI prospective cohort study in urban Bengaluru, India, pregnant women between 18 and 45 years, less than 36 weeks of gestation were included. During baseline, the participant’s age, education, physical activity levels, and food habits were recorded. Screening of GDM was done by the World Health Organization diagnostic criteria using a 2-h 75-g oral glucose tolerance test between the 24th–36th weeks of gestation. Results We included 1777 pregnant women in the study. We show that 17.6% of the women had GDM, of which 76.7% consume red meat. Red meat consumption was associated with an increased risk of GDM (aRR = 2.1, 95% CI 1.5, 2.9) after adjusting for age, family history of diabetes and socioeconomic status. Conclusion The high intake of red meat consumption in pregnancy needs further examination. Also, future evaluations should consider evaluating the risk of red meat consumption against the combined effect of inadequate consumption of vegetables, fruits, and dairy products in pregnant women. Interventions to educate women in lower socioeconomic status on inexpensive, seasonal, and healthy food might be helpful.
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Affiliation(s)
- R Deepa
- Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India
| | - Melissa Glenda Lewis
- Indian Institute of Public Health-Hyderabad, Public Health Foundation of India (PHFI), Hyderabad, India
| | - Onno C P Van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Giridhara R Babu
- Lifecourse epidemiology, Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Magadi Road I cross, SIHFW premises, Bengaluru, 560023, India. .,Public health and clinical medicine, Wellcome Trust/DBT India Alliance, New Delhi, India.
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15
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Chanda S, Dogra V, Hazarika N, Bambrah H, Sudke AK, Vig A, Hegde SK. Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units. BMJ Open 2020; 10:e037836. [PMID: 33172942 PMCID: PMC7656912 DOI: 10.1136/bmjopen-2020-037836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/09/2020] [Accepted: 09/28/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To determine the prevalence and predictors of gestational diabetes mellitus (GDM) in rural Assam, India using a network of Mobile Medical Units. STUDY DESIGN A field-based cross-sectional study. SETTINGS Rural areas of Assam state, India. PARTICIPANTS A total of 1410 pregnant women in gestational age of 24-28 weeks INTERVENTION: Identification of pregnant women in 24-28 weeks of pregnancy from villages and administering them Government of India recommended oral glucose tolerance test for GDM confirmation. PRIMARY AND SECONDARY OUTCOME MEASURES Presence of gestational diabetes among pregnant women, risk factors and predictors of GDM. RESULTS A total of 1212 pregnant women underwent the oral glucose tolerance test. One hundred and ninety-eight women were ineligible due to existing chronic diseases or very high blood glucose level before the test. The overall GDM prevalence in Assam was 16.67% (95% CI 14.61% to 18.89%). Women aged 26-30 years (adjusted odds ratio, aOR 1.70; CI 1.14 to 2.52), who passed 10th class (aOR 1.58; CI 1.05 to 2.37), belonging to Muslim religion (aOR 1.52; 95% CI 1.05 to 2.21) and above poverty line (aOR 1.38; 95% CI 1.00 to 1.91) had significantly increased likelihood of developing GDM compared with respective baseline groups (p<0.05). Body mass index, gravida and being non-anaemic were non-significant risk factors for GDM. Family history of diabetes (aOR 1.82; 95% CI 1.08 to 3.06) and smoking (aOR 1.61; 95% CI 1.10 to 2.35) were significant and independent predictors of GDM. CONCLUSION The prevalence of GDM in rural Assam is high. The mobile medical units may play a significant role in the implementation of GDM screening, diagnosis, treatment to ensure better maternal and foetal health outcomes in rural Assam.
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Affiliation(s)
- Subrata Chanda
- Clinical Domain, Piramal Swasthya Management and Reseach Institute, Guwahati, Assam, India
| | - Vishal Dogra
- Research and Analysis Wing, Piramal Swasthya Management and Reseach Institute, Hyderabad, Telangana, India
| | - Najeeb Hazarika
- Assam and North East State Office, Piramal Swasthya Management and Reseach Institute, Guwahati, Assam, India
| | - Hardeep Bambrah
- Assam and North East State Office, Piramal Swasthya Management and Reseach Institute, Guwahati, Assam, India
| | - Ajit Kisanrao Sudke
- Clinical Domain, Piramal Swasthya Management and Reseach Institute, Hyderabad, Telangana, India
| | - Anupa Vig
- Clinical Domain, Piramal Swasthya Management and Reseach Institute, Hyderabad, Telangana, India
| | - Shailendra Kumar Hegde
- Innovations, Piramal Swasthya Management and Reseach Institute, Hyderabad, Telangana, India
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Panigrahi A, Mallicka, Panda J. Gestational diabetes mellitus, its associated factors, and the pregnancy outcomes among pregnant women attending tertiary care hospitals of Bhubaneswar, India. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00798-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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17
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Wang C, Jin L, Tong M, Zhang J, Yu J, Meng W, Jin L. Prevalence of gestational diabetes mellitus and its determinants among pregnant women in Beijing. J Matern Fetal Neonatal Med 2020; 35:1337-1343. [PMID: 32316796 DOI: 10.1080/14767058.2020.1754395] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: To investigate the prevalence of gestational diabetes mellitus (GDM) and its determinants among pregnant women in the Tongzhou district of Beijing, China.Methods: This study was performed on data collected in the routine work of the prenatal health care system from 27,119 pregnant women in the Tongzhou district of Beijing during 2013-2018. Univariate and multivariate logistic regression analyses were used to assess the factors associated with GDM.Results: The overall prevalence of GDM was 24.24%, and it showed an increasing trend over the 6 years. A univariate analysis showed that the prevalence of GDM increased with age (p < .001). In multivariate analysis, it was found that women with a non-local household registration, as well as those without a local household registration but whose husbands had one, had a lower risk for GDM than both spouses who had local registration. Women who were overweight/obese had a higher risk for GDM than women with a normal pre-pregnancy body mass index. Multipara women had a lower likelihood of developing GDM.Conclusions: We found a slightly higher prevalence of GDM in the Tongzhou district of Beijing than has been found in other studies, and the prevalence rose over the 6 years of the study. Advanced age, pre-pregnancy overweight or obesity, and local household registration were important risk factors for GDM. Multiparity may be a protective factor against developing GDM. Intensive health education on related determinants should be strengthened for the prevention and control of GDM, especially in high-risk women.
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Affiliation(s)
- Cheng Wang
- Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Institute of Reproductive and Child Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Mingkun Tong
- Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Institute of Reproductive and Child Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jie Zhang
- Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Institute of Reproductive and Child Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jinhui Yu
- Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Institute of Reproductive and Child Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenying Meng
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Lei Jin
- Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Institute of Reproductive and Child Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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18
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Valadbeigi T, Tabatabaee HR, Etemad K, Keyghobadi N, Mahdavi S, Enayatrad M, Saeidinejat S, Yaghoobi H, Zolfizadeh F, Ghasemi A, Hajipour M. The association between low birth weight and mothers diseases in Iran: A case-control study. J Neonatal Perinatal Med 2019; 12:449-456. [PMID: 31256076 DOI: 10.3233/npm-180068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neonates are too vulnerable that low birth weight (LBW) and preterm birth can easily threaten their lives. Demographic, social and environmental factors as well as health care are contributing factors for LBW. The study was conducted in 10 provinces of Iran to investigate the association between LBW and mother's diseases. METHODS A case-control study was conducted in 10 provinces of Iran on 2580 mothers (712 cases and 1868 controls) referred to public health care centers. We used a questionnaire to collect data. For univariate analysis we used chi-square test and for multivariable analysis we used logistic regression model. RESULTS LBW was significantly associated with living in rural area (OR = 1.4 CI: 1.14-1.71), having body mass index (BMI)<18 (OR = 1.48 CI: 1.14-1.92), being a housewife (OR = 1.65 CI: 1.07-2.53), having high blood pressure (OR = 1.91 CI: 1.26-2.88), and having pregnancy without testing for diabetes (OR = 1.91 CI: 1.44-2.54). Minor thalassemia, hypothyroidism, oral health care and headache were not significant predictors for LBW. CONCLUSION In this study, we observed that place of residence, BMI before pregnancy, mother's occupation and gestational diabetes were significant predictors of LBW. It is necessary to improve women's awareness about prenatal health care before pregnancy to avoid LBW.
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Affiliation(s)
- T Valadbeigi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - H Reza Tabatabaee
- Department of Epidemiology, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - K Etemad
- Department of Epidemiology, Environmental and Occupational Hazards Control Research Center, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - N Keyghobadi
- Department of Biostatistics Epidemiology, Health Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - S Mahdavi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - M Enayatrad
- Department of Epidemiology, Dezful University of Medical Sciences, Dezful, Iran
| | - S Saeidinejat
- Department of Health Education and Health Promotion, School of Health Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Yaghoobi
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - F Zolfizadeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - A Ghasemi
- Birjand University of Medical Sciences, Birjand, Iran
| | - M Hajipour
- Student research committee, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, Wan Sulaiman WA, Suppiah S, Mohamed MH, Veettil SK. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18:494. [PMID: 30547769 PMCID: PMC6295048 DOI: 10.1186/s12884-018-2131-4] [Citation(s) in RCA: 229] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 11/30/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis. METHODS We systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI). RESULTS Eighty-four studies with STROBE score ≥ 14 were included in our analysis. The pooled prevalence of GDM in Asia was 11.5% (95% CI 10.9-12.1). There was considerable heterogeneity (I2 > 95%) in the prevalence of GDM in Asia, which is likely due to differences in diagnostic criteria, screening methods and study setting. Meta-analysis demonstrated that the risk factors of GDM include history of previous GDM (OR 8.42, 95% CI 5.35-13.23); macrosomia (OR 4.41, 95% CI 3.09-6.31); and congenital anomalies (OR 4.25, 95% CI 1.52-11.88). Other risk factors include a BMI ≥25 kg/m2 (OR 3.27, 95% CI 2.81-3.80); pregnancy-induced hypertension (OR 3.20, 95% CI 2.19-4.68); family history of diabetes (OR 2.77, 2.22-3.47); history of stillbirth (OR 2.39, 95% CI 1.68-3.40); polycystic ovary syndrome (OR 2.33, 95% CI1.72-3.17); history of abortion (OR 2.25, 95% CI 1.54-3.29); age ≥ 25 (OR 2.17, 95% CI 1.96-2.41); multiparity ≥2 (OR 1.37, 95% CI 1.24-1.52); and history of preterm delivery (OR 1.93, 95% CI 1.21-3.07). CONCLUSION We found a high prevalence of GDM among the Asian population. Asian women with common risk factors especially among those with history of previous GDM, congenital anomalies or macrosomia should receive additional attention from physician as high-risk cases for GDM in pregnancy. TRIAL REGISTRATION PROSPERO (2017: CRD42017070104 ).
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Affiliation(s)
- Kai Wei Lee
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Vasudevan Ramachandran
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, University of Malaya Center for Addiction Sciences (UMCAS), Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Fan Kee Hoo
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Yook Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, 47500 Bandar Sunway, Selangor Malaysia
| | - Wan Aliaa Wan Sulaiman
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Subapriya Suppiah
- Department of Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Mohd Hazmi Mohamed
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Sajesh K. Veettil
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia
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Abstract
AIMS The present study evaluates association between physical activity and Gestational Diabetes Mellitus (GDM), for it can be an effective intervention for its management. Though physical activity helps maintain glucose homeostasis, evidences of GDM risk are less extensive. Therefore, this study also identifies its correlation with maternal blood glucose levels. MATERIALS AND METHODS A prospective case-control study was carried out among pregnant women attending regular antenatal clinic at two private hospitals. The study comprised of 100 cases and 273 matched controls. Data was collected by personal interviews using a standard questionnaire. Physical activity was assessed using long form of International Physical Activity Questionnaire (IPAQ) reported as Metabolic Equivalent-Minutes per week (MET-Minutes/Week). Statistical Package for Social Sciences (SPSS) was used for analysis. RESULTS Results shows high exposure rates for low-to-moderate physical activity among cases, across all domains and sub-activities. The odds of GDM engaged in domestic and gardening activities for <2999 MET-minutes per week are 10 times higher than involved for ≥3000 MET-minutes per week (P < 0.001). The study also shows poor or no correlation between physical activity during pregnancy and maternal blood glucose levels. CONCLUSION Despite existence of poor or no relationship with maternal blood glucose levels, prolonged sedentary behavior and decreased physical activities, especially domestic, are potential risk factors for GDM, a major finding of the study.
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Affiliation(s)
- Surabhi Mishra
- Senior Resident, Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Surekha Kishore
- Professor and Head, Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
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Li KT, Naik S, Alexander M, Mathad JS. Screening and diagnosis of gestational diabetes in India: a systematic review and meta-analysis. Acta Diabetol 2018; 55:613-625. [PMID: 29582160 PMCID: PMC5999405 DOI: 10.1007/s00592-018-1131-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/14/2018] [Indexed: 02/06/2023]
Abstract
AIMS Although diabetes is rapidly increasing in India, there is no national consensus on best practices for screening, diagnosis, and management of gestational diabetes mellitus (GDM). The goal of this study was to systematically review the literature for studies reporting the prevalence and screening and diagnostic methods for gestational diabetes in India. METHODS We searched MEDLINE, Embase, and POPLINE for studies on screening for GDM in India. We included English-language full reports and conference abstracts of cross-sectional studies, prospective, and retrospective cohorts that reported the screening method and prevalence of GDM. We performed descriptive analysis on all studies and meta-analysis, meta-regression, and subgroup meta-analysis on studies with medium or low risk of bias. RESULTS We included 64 studies reporting 90 prevalence estimates. Prevalence estimates ranged from 0 to 41.9%. Subset meta-analyses showed that the IADPSG diagnostic criteria found significantly more GDM cases (prevalence = 19.19% [15.5, 23.6], p < 0.05) than the WHO 1999 criteria (10.13% [8.17, 12.50]) and DIPSI criteria (7.37% [5.2, 10.16]). Studies that compared the IADPSG and WHO 1999 criteria showed poor positive agreement (33-79%). Studies specifying time of GDM diagnosis showed that patients (11-60%) develop GDM as early as the first trimester, but many GDM cases (16-40%) are missed if screened only at first visit. CONCLUSIONS In India, prevalence estimates of GDM vary substantially by diagnostic criteria. When evaluating screening and diagnostic criteria for GDM, providers should consider their patients' needs and correlate screening criteria with pregnancy outcomes.
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Affiliation(s)
- Katherine T Li
- Weill Cornell Medical College, 1300 York Ave, New York, NY, 10065, USA.
| | - Shilpa Naik
- Department of OB-GYN, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India
| | - Mallika Alexander
- Johns Hopkins University Clinical Trials Unit, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India
| | - Jyoti S Mathad
- Departments of Medicine and OB-GYN, Weill Cornell Medicine, New York, NY, USA
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Xu X, Liu Y, Liu D, Li X, Rao Y, Sharma M, Zhao Y. Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121532. [PMID: 29292753 PMCID: PMC5750950 DOI: 10.3390/ijerph14121532] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/25/2017] [Accepted: 11/30/2017] [Indexed: 01/27/2023]
Abstract
UNLABELLED Objectives: This study aimed to identify the prevalence of gestational diabetes mellitus (GDM) and to examine its associations with social and behavioral factors, maternal body mass index (BMI), anemia, and hypertension. Methods: A cross-sectional analysis was performed on data collected from 2345 pregnant women from 16 hospitals in five selected provinces in mainland China. RESULTS Prevalence of GDM was as follows: overall: 3.7%; pregnant women in the first pregnancy: 3.4%; pregnant women in the second pregnancy: 4.6%. Compared with early pregnancy women, late-stage pregnant women were more likely to have GDM (OR = 4.32, 95% CI (1.82, 10.27)). Compared with 18-25 years old pregnant women, women aged 36-45 years were more likely to have GDM (OR = 3.98, 95% CI (1.41, 11.28). Compared with non-hypertensive patients, hypertensive patients were more likely to have GDM (OR = 6.93, 95% CI (1.28, 37.64)). However, second pregnancy, high maternal BMI, prolonged screen time (TV-viewing time, computer-using time, and mobile-phone using time), insufficient and excessive sleep duration, poor sleep quality, smoking, and secondhand smoke exposure were not significantly associated with an increased risk of GDM. Conclusions: Women in the second pregnancy do not appear to predict an increased risk for developing GDM than women in the first pregnancy. High-risk groups of GDM included women in their late pregnancy, aged 36-45 years old, and with hypertension. The findings will contribute to an improved understanding of social and behavioral determinants of GDM in Chinese population and contribute to the development of health-prevention promotion interventions to address GDM.
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Affiliation(s)
- Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Ying Liu
- School of the Second Clinical, Chongqing Medical University, Chongqing 400016, China; lyniniy @163.com
| | - Dengyuan Liu
- School of Public Health and Management, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Xiaoming Li
- School of Public Health and Management, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Yunshuang Rao
- School of Public Health and Management, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Manoj Sharma
- Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS 39213, USA.
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
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Hossain N, Shah T, Rajar S, Sehtoo A, Riaz M, Fawwad A, Basit A. Comparison of venous plasma glucose and capillary whole blood glucose in diagnosis of gestational diabetes: Study from Karachi, Pakistan. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2017. [DOI: 10.1016/j.cegh.2017.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Shahbazian H, Nouhjah S, Shahbazian N, Jahanfar S, Latifi SM, Aleali A, Shahbazian N, Saadati N. Gestational diabetes mellitus in an Iranian pregnant population using IADPSG criteria: Incidence, contributing factors and outcomes. Diabetes Metab Syndr 2016; 10:242-246. [PMID: 27350363 DOI: 10.1016/j.dsx.2016.06.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/11/2016] [Indexed: 12/16/2022]
Abstract
AIMS Different approaches for screening and diagnosis of gestational diabetes mellitus(GDM) have great impact on all process of management of gestational diabetes and its future complications. The aims of this study were to evaluate rate, risk factors and outcomes of GDM based on International Association of Diabetes and Pregnancy Study Groups diagnostic criteria. MATERIALS In a prospective study pregnant women attended 5 clinics in Ahvaz, screened for gestational diabetes mellitus using IADPSG criteria and followed up delivery from August 2014 to February 2015. At the first prenatal visit women underwent the fasting blood sugar test. A 75-g oral glucose tolerance test (OGTT) was performed for 750 mothers between 24 and 32 weeks of gestation. Logistic regression test for calculating the odds ratios and 95% confidence intervals was used. RESULTS The mean age of participants was 28.43±5.52years. The overall rate of GDM in our study was 29.9% (224/750). Incidence of gestational diabetes was associated with age group≥35years [OR=1.92(95% CI, 1.19-3.09)], family history of diabetes [OR=2.47(95% CI, 1.33-4.59)], previous GDM [OR=3.12(1.35-7.19)], BMI≥25 [OR=1, 71(1.10-2.67)] Using logistic regression. The most common maternal complication in studied women was cesarean section followed by hypertension and preeclampsia. CONCLUSION About one third of studied women diagnosed as GDM according to the IADPSG criteria. Risk factors of GDM were maternal age, family history of diabetes, Previous GDM, overweight and obesity before pregnancy, the same reported factors with 2 steps approach. Higher rate of GDM using this criterion may increase concern about healthcare costs and workloads.
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Affiliation(s)
- Hajieh Shahbazian
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sedigheh Nouhjah
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Nahid Shahbazian
- Obstetrics and Gynecology Department, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shayesteh Jahanfar
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Seyed Mahmoud Latifi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Armaghan Aleali
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasrin Shahbazian
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Najmieh Saadati
- Obstetrics and Gynecology Department, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Mohan MA, Chandrakumar A. Evaluation of prevalence and risk factors of gestational diabetes in a tertiary care hospital in Kerala. Diabetes Metab Syndr 2016; 10:68-71. [PMID: 26476488 DOI: 10.1016/j.dsx.2015.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 09/27/2015] [Indexed: 11/26/2022]
Abstract
AIMS The prospective study was conducted with the aim to evaluate the prevalence and risk factors of gestational diabetes mellitus in a tertiary care referral hospital in Kerala. MATERIALS AND METHODS A prospective observational study was conducted with the aim to study the prevalence, risk factors, complications, treatment pattern and cost analysis of GDM. The study was carried out in the Obstetrics & Gynecology dDepartment of Al Shifa hHospital located in northern Kerala. RESULTS Over an eight-month period, 201 patients who met the inclusion criteria were enrolled for study from which prevalence of GDM was estimated at 15.9%. The study revealed higher prevalence of risk factors and complications such as age >25 years, BMI >26kg/m(2), family history of DM, past history GDM, history of big baby, gestational hypertension, vaginal candidiasis, premature rupture of membranes and hyperbilirubinemia in GDM group as compared to non-GDM group. The study also demonstrated that modern life-style was a major influencing factor for development of diabetes in the study population. CONCLUSION The study reveals the necessity of proper screening diagnosis and management of GDM in pregnant women by the clinicians so as to prevent the future burden of type 2 diabetes.
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Affiliation(s)
- Manju A Mohan
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kizhattur, Poonthavanam P.O, Perinthalmanna 679322, Kerala, India.
| | - Abin Chandrakumar
- Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kizhattur, Poonthavanam P.O, Perinthalmanna 679322, Kerala, India.
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Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India. PLoS One 2016; 11:e0151311. [PMID: 26991305 PMCID: PMC4798719 DOI: 10.1371/journal.pone.0151311] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/26/2016] [Indexed: 12/05/2022] Open
Abstract
Introduction Hyperglycaemia in pregnancy (HIP), i.e. gestational diabetes mellitus (GDM) and diabetes in pregnancy (DIP), increases the risk of various short- and long-term adverse outcomes. However, much remains to be understood about the role of different risk factors in development of HIP. Objective The aims of this observational study were to examine the role of potential risk factors for HIP, and to investigate whether any single or accumulated risk factor(s) could be used to predict HIP among women attending GDM screening at three centres in urban, semi-urban and rural Tamil Nadu, India. Methodology Pregnant women underwent a 75 g oral glucose tolerance test. Data on potential risk factors was collected and analysed using logistical regression analysis. Receiver operating characteristic (ROC) curves, sensitivity, specificity and predictive values were calculated for significant risk factors and a risk factor scoring variable was constructed. Results HIP was prevalent in 18.9% of the study population (16.3% GDM; 2.6% DIP). Increasing age and BMI as well as having a mother only or both parents with diabetes were significant independent risk factors for HIP. Among women attending the rural health centre a doubling of income corresponded to an 80% increased risk of HIP (OR 1.80, 95%CI 1.10–2.93; p = 0.019), whereas it was not significantly associated with HIP among women attending the other health centres. The performance of the individual risk factors and the constructed scoring variable differed substantially between the three health centres, but none of them were good enough to discriminate between those with and without HIP. Conclusions The findings highlight the importance of socio-economic circumstances and intergenerational risk transmission in the occurrence of HIP as well as the need for universal screening.
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Tong GX, Cheng J, Chai J, Geng QQ, Chen PL, Shen XR, Liang H, Wang DB. Association between gestational diabetes mellitus and subsequent risk of cancer: a systematic review of epidemiological studies. Asian Pac J Cancer Prev 2015; 15:4265-9. [PMID: 24935382 DOI: 10.7314/apjcp.2014.15.10.4265] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. MATERIALS AND METHODS We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. RESULTS A total of 9 articles documented 5 cohort and 4 case- control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. CONCLUSIONS Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.
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Affiliation(s)
- Gui-Xian Tong
- Center for Health Management, School of Health Services Management, Anhui Medical University, Hefei, China E-mail :
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Jia X, Wang S, Ma N, Li X, Guo L, Liu X, Dong T, Liu Y, Lu Q. Comparative analysis of vaspin in pregnant women with and without gestational diabetes mellitus and healthy non-pregnant women. Endocrine 2015; 48:533-40. [PMID: 24929806 DOI: 10.1007/s12020-014-0318-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 05/23/2014] [Indexed: 01/01/2023]
Abstract
To explore serum vaspin, leptin, and adiponectin levels and their correlation with insulin resistance (IR) in pregnant women with and without gestational diabetes mellitus (GDM) and healthy non-pregnant women. A total of 262 individuals, including pregnant women with GDM (n = 86), those without GDM (n = 92), and age-matched healthy non-pregnant women (n = 84) were enrolled in this case-control study. Vaspin, leptin, adiponectin, glucose, insulin, hemoglobin A1C (HbA1c), and lipid parameters were measured. The homeostasis model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index, and body mass index were calculated. Data inferred higher concentrations of vaspin (2.72 ± 2.20 vs. 1.84 ± 1.57 vs. 0.81 ± 1.02) in GDM than during normal pregnancy and in non-pregnant women, higher leptin (23.42 ± 12.18 vs. 22.19 ± 10.55 vs. 12.10 ± 11.26), and lower adiponectin (4,164.83 ± 2,650.39 vs. 4,871.66 ± 2,803.51 vs. 7,202.85 ± 4,893.13) in GDM and normal pregnancy as compared to non-pregnant women (p < 0.05). Vaspin was positively correlated to leptin (r = 0.273, p = 0.012), HOMA-IR (r = 0.387, p = 0.000), and triglycerides (TG, r = 0.218, p = 0.046) in GDM. In addition, leptin was negatively correlated to adiponectin in GDM (r = -0.336, p = 0.002) and normal pregnancy (r = -0.256, p = 0.014). Furthermore, vaspin was significantly correlated to GDM and HOMA-IR, and the weight gain might play a vital role in the occurrence of GDM. During pregnancy, high vaspin concentration is significantly associated with IR in GDM.
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Affiliation(s)
- Xiaojiao Jia
- Department of Endocrinology, Hebei Medical University, Shijiazhuang, China
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Dave VR, Rana BM, Sonaliya KN, Chandwani SJ, Sharma SV, Khatri SO, Shaikh KM, Hathiari FM. Screening of Gestational Diabetes and Hypertension Among Antenatal Women in Rural West India. Cent Asian J Glob Health 2014; 3:140. [PMID: 29755888 PMCID: PMC5927732 DOI: 10.5195/cajgh.2014.140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Hypertension and gestational diabetes are among the leading causes of maternal and perinatal mortality, especially in rural areas of developing countries with meager health facilities. With early diagnosis and timely treatment, these adverse events can be decreased. The primary aim of this study was to implement a screening program for gestational diabetes and hypertension, and to assess risk factors associated with these conditions among antenatal women in the rural area of the Gujarat province in India. Methods A cross–sectional study was conducted at one of the rural areas of Gujarat province in India. Following a random cluster sampling procedure, the village of Davas was selected. A multistage random sampling method was utilized, resulting in a sample of 346 antenatal women. Screening guidelines from the American Diabetes Association were followed for gestational diabetes screening. Results The majority of antenatal mothers (55.50%) were between 21–25 years of age. 242 antenatal women were multigravida, and among them, 85.96% had institutional delivery at their last pregnancy. Of the total 346 women, 17.60% were prehypertensive. The prevalence of systolic hypertension was 1.40%, diastolic hypertension was 0.90%, and gestational diabetes was 1.73%. Conclusion Socioeconomically upper class, a family history of hypertension, and BMI ≥ 25 were strong risk factors for hypertension during pregnancy and gestational diabetes. Health education should be made readily available to antenatal mothers by paramedical workers regarding symptoms of hypertension and gestational diabetes mellitus for early self identification.
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Affiliation(s)
- Viral R Dave
- Community Medicine Department, Gujarat Cancer Society (GCS) Medical College, Ahmedabad, Gujarat, India
| | - Bhavik M Rana
- Community Medicine Department, Gujarat Cancer Society (GCS) Medical College, Ahmedabad, Gujarat, India
| | - Kantibhai N Sonaliya
- Community Medicine Department, Gujarat Cancer Society (GCS) Medical College, Ahmedabad, Gujarat, India
| | - Suraj J Chandwani
- Gujarat Cancer Society (GCS) Medical College Hospital & Research Centre, Ahmedabad, Gujarat, India
| | - Samkit V Sharma
- Gujarat Cancer Society (GCS) Medical College Hospital & Research Centre, Ahmedabad, Gujarat, India
| | - Swati O Khatri
- Gujarat Cancer Society (GCS) Medical College Hospital & Research Centre, Ahmedabad, Gujarat, India
| | - Khalid M Shaikh
- Gujarat Cancer Society (GCS) Medical College Hospital & Research Centre, Ahmedabad, Gujarat, India
| | - Farida M Hathiari
- Gujarat Cancer Society (GCS) Medical College Hospital & Research Centre, Ahmedabad, Gujarat, India
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