Maternal Age and Prevalence of Gestational Diabetes Mellitus

Lao, Terence T.; Ho, Lai Fong; Chan, Ben; Leung, WC

doi:10.2337/diacare.29.04.06.dc05-2568

Cited by 116 publications

(87 citation statements)

References 7 publications

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“…The worsening of glucose tolerance was directly associated with age [27],non-Caucasian ethnicity, lower education levels, lower family income [28], lower weight and length at birth [29], lower height and shorter legs in adulthood [30], higher BMI, larger waist, larger waist-to-hip ratio [25,31], higher systolic and diastolic blood pressure [32]. Laboratory findings of lower HDL cholesterol and higher levels of VLDL cholesterol and triglycerides were also associated with a worsening of glucose tolerance.…”

Section: Discussionmentioning

confidence: 99%

Mild gestational hyperglycaemia as a risk factor for metabolic syndrome in pregnancy and adverse perinatal outcomes

Negrato

Jovanovič

Tambascia

et al. 2008

Diabetes Metabolism Res

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Section: Discussionmentioning

confidence: 99%

Mild gestational hyperglycaemia as a risk factor for metabolic syndrome in pregnancy and adverse perinatal outcomes

Negrato

Jovanovič

Tambascia

et al. 2008

Diabetes Metabolism Res

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“…The two literatures that were critically reviewed had indicated disparity prevalence of GDM but unidirectional change. 21,22 Therefore, this report provides another contrary evidence for consideration.…”

Section: Discussionmentioning

confidence: 67%

“…The current notion or suggestion is that is that GDM screening should be limited to women who are above 25 years. 21 Therefore, it may be taken that this observation justifies the need to exclude antenatal patients who are below 25 years from GDM screening unless there is a history of diabetes or CVDs in the family or the are symptoms of BM.…”

Section: Discussionmentioning

confidence: 99%

“…6,21 On this basis, there is a 25 years cut-off speculated as recommendation of minimum age for antenatal patients to qualify for GDM screening, but it is acknowledged that research evidence is lacking to support this recommendation. 21 However, a critical review of available two literatures on prevalence of GDM in stratified age-groups do suggest unidirectional increase with age ( Figure 1). Given the foregoing, it may benefit the low-mid income communities to ascertain the cost effectiveness of universal screening compared to selectively excluding patients who are below 25 years old.…”

mentioning

confidence: 99%

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Screening for gestational diabetes: evaluation of prevalence in age-stratified subgroups at Central hospital Warri Nigeria

Orru

Nwose

Bwititi³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: The prevalence of gestational diabetes depends on the method of diagnosis as well as ethnic background. Maternal age has also been identified as a factor, but has not been given much attention. The notion of gestational prediabetes has also speculated, but is equally yet to be a focus in discussion. Aim: This work aimed at evaluating the screening for gestational diabetes in Central Hospital, Warri; to determine prevalence of gestational diabetes in the general population and in stratified age groups. The other objective was to investigate the effectiveness and use of the methods of diagnosis. Materials and Methods: This was a retrospective review of laboratory data of de-identified antenatal patients. Hospital records of gestational diabetes from 2013 to 2015 were obtained from the Central Hospital, Warri. Data collected included age of the de-identified patients, blood glucose results and whether the test was fasting or random. Other information was the month/year of test. A total of 3 589 results were analyzed. Results: Averaged prevalence of 5.85% is identified. Fasting blood sugar (FBS) measurement was used more and it also identified more positives (9%) compared to random blood sugar (<2%). On a dichotomous age group, prevalence of gestational diabetes appeared low in women below 25 years compared to those ≥26 years old. In a more stratification of age groups, potential antepartum prediabetes in pregnancy was lower in women above 40 years old relative to the younger age subpopulations (p < 0.000001). No significant variation was observed in level of usage of either method between months/years. Conclusion: There is an ongoing good practice of using affordable screening test, which is FBS. The significant finding was that there may be up to 9% prevalence of GDM and that this number may erroneously be lower if random blood glucose measurement is used. Another worthy observation was that the prevalence in stratified age groups was non-directional, especially as prediabetes appears higher in the younger age subpopulation.

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“…Studies in the past have shown that maternal age more than 25 years is most predictive factor of GDM. 8 50% subjects in present study were found to be GDM which shows the high prevalence in our south indian population where the study was conducted. The prevalence of GDM has increased probably because of stringent second trimester screening by IADPSG criteria.…”

Section: Discussionmentioning

confidence: 85%

Use of glycosylated HbA1c and random blood sugar as a screening tool for gestational diabetes mellitus in first trimester

Amreen¹,

Mundkur²,

Shetty³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONGestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. It is well known that GDM is associated with maternal and fetal morbidity such as polyhydramnios, preeclampsia, operative delivery, macrosomia, shoulder dystocia, intrauterine growth retardation, neonatal hypoglycaemia and perinatal mortality.The prevalence of GDM varies from 3.8% to 21% in various parts of India based on geographic location and diagnostic methods used.1 Indians are at eleven fold increased risk of developing glucose intolerance during pregnancy than European women.2 Recently WHO adopted the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, which has resulted in an increase in the detected incidence of GDM.3 The guidelines recommends that at 24-28 weeks a 75 g oral glucose tolerance test (OGTT) should be done for all pregnant women.GTT is an inconvenient test as it consumes time, the pregnant women must fast and wait for 2 hours and should have at least 3 venipunctures. They also have nausea and vomiting due the 75 g glucose and delayed gastric emptying. Moreover, the universal screening recommendation has increased the testing burden. With these methods there was a possibility of missing patients with abnormal sugars in first trimester. ABSTRACTBackground: GDM cases go unidentified with inadequate screening methods in first trimester which in turn increases the maternal and neonatal morbidity which is preventable. The purpose of the study was to find out a cut off level for HbA1c and RBS at first trimester for screening Gestational diabetes mellitus (GDM). Methods: Observational study on pregnant women in a tertiary care teaching institution. Early screening with HbA1c and RBS at booking visit and followed up to second trimester GTT at 24-28 weeks. Pregnant women were divided into 2 groups based on GTT results. Pregnant women with overt diabetes and multiple pregnancy were not included in the study. Results: Out of the 151 subjects, 76 cases were diagnosed with GDM while the other 75 were found to be non-GDM by following the 75g GTT approved by IADPSG. According to our study optimal cut-off for HbA1C was found to be 5.496±0.48 %, as it gives a sensitivity of 80% and specificity of 55.3%. Optimal cut-off for RBS was found to be 112±0.77 mg/dl, as it gives a sensitivity of 35.55 and specificity of 94.7%. Conclusions: Glyco Hb A1c and RBS can be used as screening tool for the diagnosis of GDM. The likelihood of having GDM at a cutoff of Glyco HbA1c 5.5% is 1.8 times and RBS level 112mg/dl is 7 times in pregnant women.

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Maternal Age and Prevalence of Gestational Diabetes Mellitus

Cited by 116 publications

References 7 publications

Mild gestational hyperglycaemia as a risk factor for metabolic syndrome in pregnancy and adverse perinatal outcomes

Mild gestational hyperglycaemia as a risk factor for metabolic syndrome in pregnancy and adverse perinatal outcomes

Screening for gestational diabetes: evaluation of prevalence in age-stratified subgroups at Central hospital Warri Nigeria

Use of glycosylated HbA1c and random blood sugar as a screening tool for gestational diabetes mellitus in first trimester

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