Diabetes in Pregnancy in Pakistani Women: Prevalence and Complications in an Indigenous South Asian Community

Abstract

The aim of this study was to determine the prevalence and complications as well as to correlate maternal and fetal outcome with glycaemic control, in a community of Pakistani women. This was a retrospective study of 6830 deliveries over a 5‐year period in a tertiary care hospital in Karachi. Either a 75 g glucose tolerance test or a screening 50 g glucose challenge was administered depending on risk factors for Gestational Diabetes Mellitus (GDM). Case records of deliveries during this period were analysed for presence of GDM or pre‐existing diabetes; glycaemic control and complications were ascertained for those with diabetes. During this period 267 (3.9 %) of the 6830 deliveries were identified as diabetic pregnancies. Of these 223 (3.3 %) had GDM and 44 (0.6 %) women had pre‐existing diabetes mellitus. Overall maternal complications were high; pre‐eclampsia (19 %), polyhydramnios (4.6 %), and threatened abortion (3.4 %). Fetal complications of macrosomia (13.1 %), intrauterine growth retardation (7.1 %), intrauterine deaths (5.3 %) were noted. Complications were higher in poorly controlled groups. We conclude that the prevalence of GDM in Pakistani women in our study was comparable to their Western counterparts but complication rates were higher, possibly due to poorer glycaemic control.

Complaints and Complications in Pregnancy: A study of ethnic Norwegian and ethnic Pakistani Women in Oslo

“…A high prevalence of gestational diabetes among older women and women of Asian origin has been reported in several other studies. 10±12 Gestational diabetes does not appear to be associated with higher rates of Downloaded by [McGill University Library] at 09:27 03 November 2014 permanent morbidity and mortality in the newborns, 13 but higher rates of fetal and maternal complications are reported in groups with poor glycemic control 11,14 and up to 60% of the women with gestational diabetes will develop diabetes later in life. 15 Intrauterine growth retardation was a common diagnosis in the Pakistani group (18.2%, OR 5 5.0).…”

Elevated levels of chemerin, leptin, and interleukin-18 in gestational diabetes mellitus

“…Gestational diabetes mellitus (GDM) effects up to 15% pregnant women worldwide [1], whereas in Pakistan GDM rates are reported to be between 6.5%-15%, however the degree of complications both to mother and fetus are somewhat higher [2]. Pregnancy induced insulin resistance has been linked to gestational hormones, but the crosstalk between adipokine and the insulin target tissues such as skeletal muscles and the liver has led to a new avenue, linking GDM with abnormal adipokine secretion [3].…”

Gestational diabetes and fetal outcome: a study in a tertiary care centre

“…3 In Europe, America and Asia, in general, the prevalence is reported to be 3-6%. [4][5][6] In comparison to the white women the Indian women are prone to GDM eleven fold, eight fold in South East Asia, and three fold in Arab and Afro-Caribbean countries. 7 It is known to cause complications in 2-3% of all the pregnancies.…”