Chebrolu Puja, Kurbude Ravi, Thakur Manju, Shah Naman, Jain Rachna
Jan Swasthya Sahyog, India.
Heliyon. 2021 Jun 28;7(7):e07431. doi: 10.1016/j.heliyon.2021.e07431. eCollection 2021 Jul.
The reported prevalence of gestational diabetes mellitus (GDM) varies widely across India. Given the short-term, long-term, and multigenerational health impacts of GDM, understanding its frequency and risk factors is important for population screening strategies. We estimated the prevalence of GDM and determined associated risk factors in rural, central India, where data is sparse.
We conducted a cross-sectional study of a convenience sample of 575 pregnant women attending antenatal care (ANC) clinics at Jan Swasthya Sahyog's (JSS) outreach clinics in rural Chhattisgarh, India. Study participants underwent a non-fasting 75g oral glucose tolerance test (OGTT) between 24-28 weeks gestation. Using Diabetes in Pregnancy Study Group of India (DIPSI) criteria, a 2-hour post-OGTT glucose ≥140 mg/dL was used to diagnose GDM.
We found 11 patients (1.9%) who met diagnostic criteria for GDM. Median age, systolic blood pressure, and diastolic blood pressure were higher in those with GDM (26 vs 23 years, p = 0.02; 117 vs 106 mmHg, p = 0.04, 77 vs 68 mmHg, p < 0.01, respectively). Pre-hypertension was associated with increased odds of GDM on multivariate analysis (OR 4.0, 95% CI: 1.1, 14.8). BMI was not associated with GDM. With appropriate management there were no differences in fetal complications between GDM and normal glucose tolerance (NGT) groups.
In rural, central India the prevalence of GDM was 1.9% in the absence of traditional risk factors such as increased BMI. Further research is needed to define the applicability of optimal screening strategies in such settings.
据报道，印度各地妊娠期糖尿病（GDM）的患病率差异很大。鉴于GDM对短期、长期和多代健康的影响，了解其发病率和危险因素对于人群筛查策略至关重要。我们估计了印度中部农村地区GDM的患病率，并确定了相关危险因素，该地区数据稀少。
我们对印度恰蒂斯加尔邦农村地区Jan Swasthya Sahyog（JSS）外展诊所接受产前护理（ANC）的575名孕妇的便利样本进行了横断面研究。研究参与者在妊娠24 - 28周期间接受了非空腹75克口服葡萄糖耐量试验（OGTT）。根据印度妊娠糖尿病研究组（DIPSI）标准，OGTT后2小时血糖≥140 mg/dL用于诊断GDM。
我们发现11名患者（1.9%）符合GDM诊断标准。GDM患者的年龄中位数、收缩压和舒张压较高（分别为26岁对23岁，p = 0.02；117 mmHg对106 mmHg，p = 0.04，77 mmHg对68 mmHg，p < 0.01）。多因素分析显示，高血压前期与GDM患病几率增加相关（OR 4.0，95% CI：1.1，14.8）。BMI与GDM无关。通过适当管理，GDM组和正常糖耐量（NGT）组之间的胎儿并发症无差异。
在印度中部农村地区，在没有BMI增加等传统危险因素的情况下，GDM患病率为1.9%。需要进一步研究来确定最佳筛查策略在此类环境中的适用性。
