Incidence and Risk Factors Related to Gestational Diabetes Mellitus among Women in Yazd: A Prospective Cohort Study

Document Type : Original Article

Authors

1 Genetic and Environmental Adventures Research Center, School of Abarkouh Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Department of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: The incidence of Gestational diabetes mellitus (GDM) is increasing worldwide. The exact prevalence of GDM in Iran is unknown. This study aimed to identify the incidence of GDM and the risk factors based on a cohort study in Yazd.
Methods: This is a prospective cohort study involving 3110 pregnant women attending prenatal clinics in Yazd, Iran between 2015 and 2020. GDM was diagnosed using an Oral Glucose Tolerance Test (OGTT) for each participant at 24-28 weeks of gestation. Demographic information was collected at enrollment and during pregnancy. The multivariate logistic regression models were used to identify risk factors for GDM.
Results: The overall incidence of GDM was 10.93% in this study. The incidence of GDM in the first, second and third trimesters were 5.65, 2.25 and 3.11%, respectively. The mean age of mothers was calculated to be 28.64 ± 5.53 years. By logistic regression, significant factors associated with GDM were age, Preeclampsia, Pregnancy High blood pressure, history of diabetes mellitus (DM) and obesity.
Conclusion: In this population, the incidence of GDM was 10.93%, which was high. The significant risk factors for GDM were age, BMI, smoking, smoking exposure in the current pregnancy and history of GDM and DM. Also, GDM pregnancies have a higher risk of preeclampsia and gestational hypertension. Therefore, considering the high incidence of GDM in Yazd, general screening is highly recommended and more studies are needed in other parts of Yazd province.

Keywords


  1. Larrabure-torrealva GT, Martinez S, Luque-fernandez MA, Sanchez SE, Mascaro PA, Ingar H, et al. Prevalence and risk factors of gestational diabetes mellitus : findings from a universal screening feasibility program in Lima, Peru. BMC Pregnancy Childbirth 2018; 18(1): 303.
  2. Yaping X, Chunhong L, Huifen Z, Fengfeng H, Huibin H, Meijing Z. Risk factors associated with gestational diabetes mellitus : a retrospective case-control study. Int J Diabetes Dev Ctries 2022; 42: 91-100.
  3. Egan AM, Vellinga A, Harreiter J, Simmons D, Desoye G, Corcoy R, et al. Epidemiology of gestational diabetes mellitus according to IADPSG/WHO 2013 criteria among obese pregnant women in Europe. Diabetologia 2017; 60(10): 1913-21.
  4. Li G, Wei T, Ni W, Zhang A, Zhang J, Xing Y, et al. Incidence and risk factors of gestational diabetes mellitus : A prospective cohort study in Qingdao, China. Front Endocrinol (Lausanne) 2020; 11: 636.
  5. Vakili M, Modaressi M, Zahabi R, Aghakoochak A. Prevalence of gestational diabetes and its risk factors in Meibod-Yazd 2013-2014. J Commun Heal Res 2016; 5(4): 270-8.
  6. Khoshnniat Nikoo M, Abbaszadeh Ahranjani S, Larijani B. A review on the prevalence of gestational diabetes mellitus (GDM) in different regions of Iran. Iran J Diabetes Lipid Disord 2009; 8(1): 47-56.
  7. Mghanga FP, Maduhu EA, Nyawale HA. Prevalence and associated factors of gestational diabetes mellitus among rural pregnant women in southern Tanzania. Ghana Med J 2020; 54(2): 82-7.
  8. Kramer CK, Campbell S, Retnakaran R. Gestational diabetes and the risk of cardiovascular disease in women : a systematic review and meta-analysis. Diabetologia 2019; 62(6); 905-14.
  9. Zhang C, Olsen SF, Hinkle SN, Gore-Langton RE, Vaag A, Grunnet LG, et al. Diabetes & Women’s Health (DWH) Study: An observational study of long-term health consequences of gestational diabetes, their determinants and underlying mechanisms in the USA and Denmark. BMJ Open 2019; 9(4): e025517.
  10. Stark S, Linder B, Cowie CC. Prevalence of gestational diabetes and subsequent Type 2 diabetes among U.S. women. Diabetes Res Clin Pract 2018; 141: 200-8.
  11. Parham M, Bagherzadeh M, Ghasembeglou MH, Vafaeimanesh J. Gestational diabetes; worrisome prevalence. J Biostat Epidemiol 2018; 4(4): 216-21.
  12. Carroll X, Liang X, Zhang W, Zhang W, Liu G, Turner N, et al. Socioeconomic, environmental and lifestyle factors associated with gestational diabetes mellitus : A matched case-control study in Beijing, China. Sci Rep 2018; 8(1): 8103.
  13. Wagan N, Amanullah AT, Makhijani PB, Kumari R. Factors associated with gestational diabetes mellitus: A cross-sectional study. Cureus 2021; 13(8): e17113.
  14. Lookzadeh MH, Alipour MR, Vakili-Zarch A, Ekraminasab S. Prevalence of congenital heart diseases in neonates of diabetic mothers: A cross sectional study in Yazd. World J Peri Neonatol 2022; 5(1): 24-9.
  15. Asiedu-Danso M, Kretchy IA, Sekyi JK, Koduah A. Adherence to antidiabetic medications among women with gestational diabetes. J Diabetes Res 2021; 2021: 9941538.
  16. Behboudi-Gandevani S, Amiri M, Bidhendi Yarandi R, Ramezani Tehrani F. The impact of diagnostic criteria for gestational diabetes on its prevalence: A systematic review and meta-analysis. Diabetol Metab Syndr 2019; 11(1): 11.
  17. Groof Z, Garashi G, Husain H, Owayed S, AlBader S, Mouhsen H, et al. Prevalence, risk factors, and fetomaternal outcomes of gestational diabetes mellitus in Kuwait: A cross-sectional study. J Diabetes Res 2019; 2019: 9136250.
  18. Stacey T, Tennant PWG, McCowan LME, Mitchell EA, Budd J, Li M, et al. Gestational diabetes and the risk of late stillbirth: a case-control study from England, UK. BJOG An Int J Obstet Gynaecol 2019; 126(8): 973-82.
  19. Jafari-Shobeiri M, Ghojazadeh M, Azami-Aghdash S, Naghavi-Behzad M, Piri R, Pourali-Akbar Y, et al. Prevalence and risk factors of gestational diabetes in Iran: A systematic review and meta-analysis. Iran J Public Health 2015; 44(8): 1036-44.
  20. Vakili M, Rahimi Pardanjani S, Alipour N, Taheri M, Baeradeh N, Hashemi A. The prevalence of gestational diabetes and associated factors in pregnant women referred to health care centers of Yazd in 2012 [in Persian]. J Sabzevar Univ Med Sci 2014; 21(6): 1214-24.
  21. Khadivzadeh T, Rajati R, Esmaeili H, Danesh F. The relationship of the current and desired number of children with the quality of marital relationship and fertility motivations among employed women and their husbands. J Midwifery Reprod Heal 2021; 9(1): 2573-81.