Prevalence of gestational diabetes mellitus and its associated risk indicators: A hospital based study in Nepal

Abstract

Background: Gestational diabetes mellitus is increasing enormously worldwide in the recent decades especially in developing countries. The prevalence of Gestational Diabetes mellitus (GDM) differs depending on the regions and the country. Nearly half of women with a history of GDM develop type 2 diabetes within five to ten years after delivery. Out of 25 pregnancies 1 develop GDM which is associated with complications in the period immediately before and after birth. It is one of the causes of maternal and fetal mortality and morbidity. Due to lack of data on prevalence of GDM, particularly from Nepal we conducted the study. Objectives: The goal of the study is to determine the prevalence and to identify associated risk indicators of GDM. Methods: Design & source of data: A cross sectional epidemiological study was conducted in urban antenatal clinic in Nepal for 6 months (1st July-31st December 2013). 510 eligible pregnant women who were willing to take part in the study between 24 and 28 weeks of pregnancy were the recruited participants. All of them underwent 50gm GCT followed by 75gm OGTT, if the value of GCT≥ 140mg/dl, to confirm GDM. Descriptive, univariate and multivariate binary logistic regression was done to see the effect modification of GDM on different variables. Results: GDM was diagnosed in 22 (4.3%) women. In this study, the progressing maternal age was independent risk indicators for GDM in univariate and multivariate analysis. In overweight and obesity BMI was found significant in univariate analysis. The non-vegetarians had 70% risk of being overweight and obese and 3 folds probability to develop GDM than vegetarians. No significant association with GDM was found for physical activity, parity, education, occupation, socio-economic status. Conclusion: Appropriate intervention is needed for control and risk indicator modification for GDM. Absence of association of GDM with important risk indicators is due to lack of statistical power.