Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
Sci Rep. 2024 Oct 24;14(1):25253. doi: 10.1038/s41598-024-76863-3.
Gestational Diabetes Mellitus (GDM) is associated with adverse maternal and perinatal outcomes and increased risk of developing diabetes in later life. Sri Lanka adopted universal GDM screening at two time points in pregnancy (before 12 weeks and between 24 and 28 weeks) in 2014 and its utilization has not been assessed. This study assessed the utilization of GDM screening services and associated factors among antenatal mothers in Southern Sri Lanka. A cross-sectional study was carried out in a consecutive sample of 420 postpartum mothers who delivered at three major hospitals in Sri Lanka. Data were collected on socio-demographics, pregnancy, availability and utilization of screening services and logistics using an interviewer-administered questionnaire and a data record sheet. Data was analysed using SPSS software. Chi-square test and binary logistic regression was used to assess the association between variables. The coverage of first and second screening tests were 91.4% and 94.5% and timeliness were 72.4% and 59.5%, respectively. The median period of amenorrhoea at the first and second screening were 10.0 (inter-quartile range: 2.5) weeks and 28.0 (inter-quartile range: 1.5) weeks. A higher utilization was associated with higher income (OR = 3.4, 95% CI: 1.1-10.5) and planned pregnancy (OR = 4.9, 95% CI: 2.2-10.7) for the first screening test. Primiparity (OR = 0.3, 95% CI: 0.1-0.9) and proximity of the nearest laboratory (OR = 3.5, 95% CI: 1.0-12.0) were positively associated with the second screening test. The timeliness of both screening tests was associated with planned pregnancy (OR = 2.1, 95% CI: 1.1-4.0 and OR = 2.3, 95% CI: 1.1-4.5) and being non-employed during the pregnancy (OR = 2.5, 95% CI: 1.4-4.3 and OR = 2.3, 95% CI: 1.3-4.1). A high utilization of GDM screening was observed. Timeliness should be ensured through improved availability and accessibility of screening facilities.
妊娠期糖尿病（GDM）与母婴不良结局和日后发生糖尿病的风险增加有关。斯里兰卡于 2014 年在妊娠的两个时间点（12 周前和 24-28 周）采用了普遍的 GDM 筛查，但其利用率尚未评估。本研究评估了斯里兰卡南部产前母亲的 GDM 筛查服务的利用情况及其相关因素。在斯里兰卡的三家主要医院中，对连续抽取的 420 名产后母亲进行了一项横断面研究。使用访谈式调查问卷和数据记录表收集了社会人口统计学、妊娠、筛查服务的可用性和利用情况以及后勤方面的数据。使用 SPSS 软件进行数据分析。卡方检验和二项逻辑回归用于评估变量之间的关联。首次和第二次筛查测试的覆盖率分别为 91.4%和 94.5%，及时性分别为 72.4%和 59.5%。第一次和第二次筛查的闭经中位数分别为 10.0（四分位距：2.5）周和 28.0（四分位距：1.5）周。更高的利用率与更高的收入（OR=3.4，95%CI：1.1-10.5）和计划妊娠（OR=4.9，95%CI：2.2-10.7）相关，第一次筛查。初产妇（OR=0.3，95%CI：0.1-0.9）和最近实验室的距离（OR=3.5，95%CI：1.0-12.0）与第二次筛查呈正相关。两次筛查的及时性均与计划妊娠（OR=2.1，95%CI：1.1-4.0 和 OR=2.3，95%CI：1.1-4.5）和妊娠期间非就业（OR=2.5，95%CI：1.4-4.3 和 OR=2.3，95%CI：1.3-4.1）相关。GDM 筛查的利用率很高。应通过改善筛查设施的可用性和可及性来确保及时性。
