Prevalence of gestational diabetes mellitus in trabzon province and risk factors affecting prevalence

Aim: Major aims of the present study are to establish prevalence of gestational diabetes mellitus (GDM) according to Carpenter and Coustan criteria of ADA and risk factors including (age, level of education, occupation, monthly household income, cigarette smoking, prepregnancy BMI, weight gain during pregnancy, height, number of pregnancy and parity, a history of GDM in previous pregnancies, DM history in relatives of first degree, systolic and diastolic blood pressure) affecting prevalence and to investigate what precautions should be taken. Material and Methods: The study was done cross-sectional on 815 pregnants who apply to Trabzon family health center of Ministry of Health, Trabzon Gynecology, Obstetric and Child Disease Hospital, Farabi Hospital of Karadeniz Technical University, Faculty of Medicine and are visited on their home between May 2009 to April 2011 in the central province of Trabzon city. Anthropometric and demographic data for all pregnants included to the study by educated surveyors were obtained by a structured questionnaire form. Risk factors for GDM were interrogated, physical examinations of the pregnants were performed. The measurements of arterial blood pressure, weight and height were recorded. After questionnaire study and physical examination, GCT with 50 gram anhydrous glucose as a routine antenatal screening test (50-g GCT) for GDM according to Carpenter and Coustan criteria of ADA was done. For pregnants with GCT (+) and with GCT (-) but had high risk for GDM, 100-g 3-h OGTT was carried out after of 8-12 hour overnight fast. Serum glucose level was measured by glucose oxidase method in autoanalyzer. Diagnosis of GDM was made by Carpenter and Coustan criteria suggested by ADA. Women with GDM were followed for poor obstetric and neonatal outcomes. Results: GCT positivity was established as 22,3 % in pregnants screened. GDM prevalence was found to be 19,2 % in pregnants with GCT (+). GDM prevalence, whereas, was found to be 12,3 % for pregnants with normal GCT but with high risk for GDM. The prevalence of GDM was found to be 4,8 % for all pregnants. The mean age, prepregnancy weight and BMI, weight in pregnancy, weight gain during pregnancy and diastolic blood pressure were found to be higher in pregnants with GDM than those without GDM. Positive correlations among GDM prevalence and age, smoking cessation, prepregnancy obesity, weight gain of more than 8 kg during pregnancy, a history of GDM in previous pregnancies and presence of DM in first degree relatives of pregnant were found. In logistic regression analysis, older age, smoking cessation, prepregnancy obesity, weight gain of more than 8 kg during pregnancy, GDM history in previous pregnancies and DM history in first degree relatives of pregnant were found as independent risk factors for increased prevalence of GDM. A significant relationship among GDM prevalence and education level, occupation, monthly household income, height, number of pregnancy and delivery, GDM history in family, systolic and diastolic blood pressure was not found. Rates for macrosomic infant, polyhydramnios, devolopment of preeclampsia, the mean birth weights of delivered babies and cesarean delivery were significantly higher for pregnants with GDM than those without GDM. Conclusion: The prevalence of GDM in Trabzon province was found as moderate. But, the present study suggest that the increased prevalence may be lead to poor obstetric and neonatal outcomes. It was concluded that required precautions including effective public health education and balanced nutrition should be provided.