Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons
Abdulbari Bener1,2, Najah M Saleh3, Abdulla Al-Hamaq4
1Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Department of Public Health and Medical Education, Weill Cornell Medical College, Qatar; 2Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK; 3Department of Obstetrics and Gynecology, Women's Hospital, Hamad Medical Corporation, Qatar; 4Qatar Diabetes Association and Qatar Foundation, Qatar
Background: The prevalence of gestational diabetes (GDM) is increasing all over the world. Hence, the impact of GDM on maternal and infant health is an important topic of research. No study has been conducted in Qatar to evaluate the outcome of pregnancies complicated by diabetes mellitus.
Objective: The aim of the study was to determine the prevalence of GDM, compare the maternal–neonatal complications among women with GDM and non-GDM pregnant women, and investigate the risk factors and potential outcomes associated with GDM.
Design: This is a prospective cohort study.
Setting: The survey was carried out at the antenatal clinics of the Women's Hospital, Qatar.
Subjects and methods: A representative sample of 2056 pregnant women who attended the antenatal clinics of the Women's Hospital were surveyed during the period from the first week of January 2010 to April 2011. From this sample, 1608 women (78.2%) expressed their consent to participate in the study. Questionnaires were administered to pregnant women who were seeking antenatal care at this urban hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome.
Results: The prevalence of GDM in Qatar was 16.3%. Women with GDM were significantly higher in the age group of 35–45 years (45%; P = 0.001). Family history of diabetes (31.7%; P < 0.001), increased parity (55.3%; P = 0.004), and obesity (59.2%; P < 0.001) were determinants of GDM in pregnant women. Maternal complications like pregnancy-induced hypertension (19.1% vs 10.3%; P <0.001), pre-eclampsia (7.3% vs 3.8%; P = 0.012), antepartum hemorrhage (19.2% vs 14.6%; P = 0.05), and cesarean (27.9% vs 12.4%; P < 0.001) were significantly higher in GDM women. Neonates were at increased risk of preterm birth (12.6% vs 8.3%; P = 0.03), macrosomia (10.3% vs 5.9%; P = 0.01), and birth trauma (8% vs 3%; P < 0.001).
Conclusion: The study findings revealed that GDM was higher in women in Qatar and that they were at increased risk of developing maternal and neonatal complications. Obesity emerged as an essential risk factor for subsequent GDM. The advanced maternal age, low monthly income, family history of diabetes, and obesity were the main significant risk factors for GDM.
Keywords: gestational diabetes, obstetric risks, macrosomic, Qatar
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