A population-based screening for gestational diabetes mellitus in non-diabetic women in Bahrain

Abstract

BACKGROUNDMaternal hyperglycemia is considered a risk factor for fetal morbidity. Since there is a high prevalence of diabetes mellitus among the population of Bahrain, we conducted a prospective population-based study of gestational diabetes mellitus (GDM) in non-diabetic pregnant women.SUBJECTS AND METHODSAll non-diabetic pregnant women attending antenatal clinics during January 2001 to December 2002 (n=10 495) were screened for GDM during the 24th to 28th weeks of gestation. All positive subjects based on a 50-g glucose challenge test (GCT) were further evaluated by a diagnostic 75-g oral glucose tolerance test (OGTT). The birth weight of the child and post-delivery insulin resistance were monitored. The homeostasis model of insulin resistance (HOMA-IR) was used to assess insulin resistance.RESULTSOf 10 495 non-diabetic pregnant women screened, 32.8% (n=3443) had plasma glucose ≥7.8 mmol/L (140 mg/dL) in the GCT. The 75-g OGTT found a prevalence of GDM of 13.5%. There were twice as many Bahrainis as expatriates. Of children born to women with GDM, 6.5% had a birth weight >4000 g. Post-delivery evaluation of insulin resistance indicated that 33% of women with GDM had a HOMA-IR value >2.CONCLUSIONThe population of Bahrain is a high-risk ethnic group for GDM. The association of insulin resistance in the post-gravid state with GDM among 33% of the study population suggests that insulin resistance, the possible cause of the pathophysiological mechanism underlying the development of gestational diabetes, continues in the post gravid state.

The impact of diagnostic criteria for gestational diabetes on its prevalence: a systematic review and meta-analysis

“…Details of the quality assessment of studies included are presented in Additional file 1: Tables S1, S2. Twenty-six studies were classified as high [16, 23–47], and 25 as moderate [8, 48–71]; no study had low quality. A total of 33.3% studies were cross-sectional and 66.6% were prospective or retrospective cohorts published between 1993 and 2017.…”

“…A total of 33.3% studies were cross-sectional and 66.6% were prospective or retrospective cohorts published between 1993 and 2017. Thirty-five studies were cohort [8, 16, 23, 25–27, 30–34, 38–40, 42, 43, 45, 46, 48, 50, 51, 54, 55, 57, 60–66, 69, 71, 72] and 16 cross-sectional [24, 28, 29, 35–37, 41, 44, 47, 49, 52, 53, 56, 67, 68, 70]. Fourteen (27.4%) studies, classified as group 1 [16, 33, 35, 37, 39, 42, 49, 59, 60, 62, 68–71] used IADPSG; 6 (11.7%) as group 2 [24, 41, 43, 47, 50, 54], 11 (21.5%) as group 3 [28, 31, 55–58, 63–67], 2 (3.9%) as group 4 [36, 53], 11 (21.5%) as group 5 [23, 27, 30, 32, 38, 40, 44–46, 51, 52], 4 (7.8%) as group 6 [8, 29, 34, 48] and 3 (5.8%) as group 7 [25, 26, 61].…”

“…In addition, 13 studies were conducted in the USA and Canada [8, 25, 29, 30, 32, 34, 38, 44, 46, 48, 51, 57, 60], five in Australia [24, 41, 43, 50, 54], seven in China and Japan [26, 33, 35, 45, 47, 52, 71], 9 in north Europe [31, 36, 42, 53, 55, 59, 61, 62, 68], six in India, Bangladesh and Sri Lanka [37, 49, 56, 64, 65, 67] and 10 were from other countries [23, 27, 28, 39, 40, 58, 63, 66, 69, 70], including Bahrain, Israel, Croatia, Argentina, Brazil, Ethiopia and Saudi Arabia. One study by the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group was originally performed in nine countries [16].…”

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

“…The size of the cohorts ranged from 23 pregnant women with a known diagnosis of idiopathic thrombocytopenic in Saudi Arabia [62] to 158,006 delivering mothers in Kuwait [81]. Majority (64.2%) of the cohort studies were in Saudi Arabia [25][26][27]40 [54,55,78,[102][103][104], and one (1.2%) in Bahrain [22] (see Additional file 3: Table S2).…”

“…There are number of cohort studies that have been conducted in the GCC countries that pertain to specific exposures and outcomes affecting maternal and infant health [19][20][21][22]. These include anthropometric, environmental, socioeconomic, lifestyle, and medical physiological exposures that can bear consequences on the pregnancy condition, delivery process, neonatal status, perinatal growth, and possibly long-term health consequences for both the mother and offspring [23][24][25][26][27].…”