Increasing Prevalence of Gestational Diabetes Mellitus

Ferrara, Assiamira

doi:10.2337/dc07-s206

Cited by 1,025 publications

(810 citation statements)

References 35 publications

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“…Associated with the global epidemic of adult and childhood obesity, gestational diabetes mellitus (GDM) is also increasingly prevalent in both developed and developing countries (Ferrara, 2007). GDM, defined as carbohydrate intolerance with onset during pregnancy, affects fetal growth and development through the altered intrauterine environment and causes fetal overgrowth (Pederson et al, 1954).…”

Section: Introductionmentioning

confidence: 99%

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Raynes‐Greenow

Turner

et al. 2016

Midwifery

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a b s t r a c tObjective: Pregnancies complicated with gestational diabetes mellitus (GDM) are at a higher risk for caesarean and instrumental deliveries as well as adverse neonatal outcomes such as fetal overgrowth, hypoglycaemia and neonatal intensive care admission. Our primary objective was to describe neonatal outcomes in a sample that included term infants of both GDM mothers and mothers with normal glucose tolerance (NGT). Design and setting: this cross-sectional study included 599 term babies born between September and October 2010 at Royal Prince Alfred Hospital, Sydney, Australia. Maternal and neonatal data were collected from medical records and a questionnaire. Glycaemic control data was based on third trimester HbA1c levels and self-monitoring blood glucose levels (BGL). Univariate associations between GDM status and maternal demographic factors, as well as pregnancy outcomes, were estimated using χ 2 tests and t-tests, as appropriate. Findings: of 599 babies, 67(11%) were born to GDM mothers. GDM mothers were more likely to be overweight/obese and of Asian ethnicity. Good glycaemic control was achieved in most GDM mothers. GDM babies were more likely to have been induced (p ¼0.013) and delivered earlier than non-GDM mothers (p o0.001), and they were also more likely to be breastfed within one hour of birth. Conclusions and implications for practice: in this study, GDM infants were more likely to be induced and delivered earlier but otherwise they did not have significantly different neonatal outcomes compared to infants of NGT mothers. This can be attributed to the good GDM control by lifestyle modification and insulin if necessary. The role of labour induction in GDM pregnancies should be further investigated. Midwives have an important role in maternal education during pregnancy and in the postnatal period.

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Section: Introductionmentioning

confidence: 99%

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Raynes‐Greenow

Turner

et al. 2016

Midwifery

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“…About 1% -14% of all pregnancies are complicated by diabetes mellitus and 90% of them are Gestational diabetes mellitus. Nearly 50% of women with GDM will become will become overt diabetes (Type-2) over a period of 5 -20 years [3]. Depending on geographical location and diagnostic methods used, the prevalence of GDM varied from 3.8% -21% in different parts of the India [4].…”

Section: Introductionmentioning

confidence: 99%

Maternal and Fetal Outcome in Gestational Diabetes Mellitus—A Study at Tertiary Health Centre in Northern India

Dahiya¹,

Sahu²,

Dahiya³

2014

OALib

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Gestational diabetes mellitus is one of the most common medical disorders found in pregnancy. Clinical recognition of GDM is important because timely intervention by dietary measures or insulin and fetal surveillance can reduce the well described associated maternal and fetal complications. This observational study was done in PGIMS, Rohtak over a period of one year. Single step test using 75 gms oral glucose was used as screening and diagnostic test for GDM. Feto-maternal outcome was studied in all the subjects. Prevalence of GDM was 7%. Age ≥ 25 years, obesity, multigravidity and family history of diabetes mellitus were major risk factors for developing GDM. Maternal and fetal outcomes were poor in GDM group as compared to the control group. In GDM group common maternal complications were polyhydroamnios and recurrent vaginal infections. Rate of caesarean section was higher in GDM group. Babies born to GDM mothers had higher incidence of metabolic complications and macrosomia.

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“…the United States, 5%-17% are complicated by gestational diabetes, [4][5][6][7] and 6%-8% by one or more hypertensive disorders of pregnancy. [8][9][10] The prevalence of gestational diabetes, 4 gestational hypertension, and preeclampsia 4,[10][11][12] have increased, particularly in younger women.…”

Section: In 2008 Inmentioning

confidence: 99%

Emergency Room Utilization After Medically Complicated Pregnancies: A Medicaid Claims Analysis

Harris

Chang

Wang

et al. 2015

Journal of Women's Health

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Background: Women with pregnancy complications benefit from closer monitoring postpartum and beyond. Increased postpartum emergency room (ER) use may indicate unmet need for outpatient obstetrics and primary care. The purpose of this study was to evaluate whether women with pregnancy complications (gestational diabetes [GDM], gestational hypertension, and preeclampsia) have increased ER use in the first 6 months postpartum, compared with women without these complications. Methods: We conducted a retrospective population-based cohort study using a 2003-2010 Maryland Medicaid managed care claims data set, linked with U.S. Census data. Data included claims for outpatient and ER visits for women aged 12-45 years who were continuously enrolled in Medicaid for at least 100 days of pregnancy and 90 days postpartum. We used logistic regression to calculate the association between pregnancy complications and having ‡1 ER visit in the 6 months postpartum. Results: We identified 26,074 pregnancies, of which 20% were complicated by GDM, gestational hypertension, or preeclampsia. Of these complicated pregnancies, 42.1% had GDM, 35.4% had gestational hypertension, and 42.5% had preeclampsia (diagnoses were not mutually exclusive). In the 6 months postpartum, 25% of women had ‡1 ER visits. Of the complicated pregnancy group, 27.7% had ‡1 ER visit, versus 23.6% of the comparison group ( p < 0.0001). In adjusted analyses, women with a pregnancy complication were more likely to have ‡1 ER visit compared with women without these complications (odds ratio [OR]1.14, 95% confidence interval [CI] 1.05-1.23). The strength of association was highest in women under age 25 (OR 1.20, 95% CI 1.09-1.33). Preconception medical comorbidities (type 2 diabetes, chronic hypertension, obesity, asthma, mental health, and substance abuse diagnoses) were also strongly associated with postpartum ER use (OR 1.61, 95% CI 1.51-1.73). Conclusions: Pregnancy complications increased ER utilization during the 6 months postpartum, especially among women under age 25 years. Interventions that improve discharge planning and early postpartum care may decrease ER use.

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Increasing Prevalence of Gestational Diabetes Mellitus

Cited by 1,025 publications

References 35 publications

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Maternal and Fetal Outcome in Gestational Diabetes Mellitus—A Study at Tertiary Health Centre in Northern India

Emergency Room Utilization After Medically Complicated Pregnancies: A Medicaid Claims Analysis

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