Prevalence Of Gestational Diabetes Mellitus Among Pregnant Women Attending Antenatal Clinic At Three Urban Health Centres Of Belagavi – A Cross Sectional Study

Abstract

Background and Objectives Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy with or without remission after the end of pregnancy. The prevalence of GDM in India varies from 3.8 to 21% in different part of country, depending on geographical locations. GDM is associated with increased incidence of maternal hypertension, pre-eclampsia, obstetric intervention and risk of developing Diabetes mellitus (DM) in later life. Hence, this study was undertaken to find out prevalence of gestational diabetes mellitus in pregnant women attending Antenatal Clinic of three Urban Health Centres (UHCs) and to determine the risk factors associated with gestational diabetes mellitus. Methodology This one year cross sectional study was done in three UHCs Ashok Nagar, Ram Nagar and Rukmini Nagar, which are urban field practice area of Jawaharlal Nehru Medical College, Belagavi. Data was collected from 360 pregnant women attending the antenatal clinic of three UHCs. Information on socio demographic details and risk factors associated with GDM was obtained. Woman was given a standardized 75gm of oral glucose load, irrespective of whether she was in fasting or non fasting state and without regard to time of last meal, and plasma glucose was estimated at 2 hours by using Diabetes in Pregnancy Study group India (DIPSI criteria) and all women with a plasma glucose of ≥ 140 mg/dl were diagnosed to have GDM. Results The prevalence of GDM in this study was 12.2%. In the present study mean age of study participants was 24.3±3.92 years, 54.7% were Muslim by religion. A large number of study participants had studied up to high school 37.8%. As many 95.3% pregnant women were housewives. Most of participants belonged to class III socio-economic status as per modified B G Prasad classification. In this study, 48.1% pregnant women were in first trimester. 53.3% were multigravida and 46.7% were primigravida. History of abortion was present in 15.2% participants of study participants. Only 1.1% participants had previous history of GDM and 1.6% participants had previous history of macrosomia. Majority 70.8% did not have family history of diabetes and 38.3% pregnant women did not have any physical activity. Mean BMI of the study participants was 22.48±3.05 kg/m2. There was statistically significant difference was observed in risk factors such as age, gravidity, previous history of abortion, previous history of GDM, previous history of macrosomia, previous history of LSCS, family history of diabetes and physical activity with GDM. The trends association was observed statistically significant in age associated with GDM (p=0.012) as the age was increased the prevalence of GDM was increased. In BMI trends association was observed statistically significant as the BMI increased the prevalence of GDM was increased (p=0.007) and in socio-economic status the trends of prevalence of GDM decreased as socio-economic status decreased which was found to be statistically significant also (p=0.03) in this study. . Conclusion In this study there is a greater prevalence of GDM in women with increasing age, higher parity, increasing BMI and a family history of diabetes mellitus. There is a need for universal screening to pick up gestational diabetes mellitus to prevent both maternal and fetal morbidity. Based on these results it concluded that, the diagnosis of GDM based on DIPSI method is a convenient, quick and cost effective.