Feasibility of setting up a birth cohort and screening Gestational Hyperglycemia in Public health facilities in Bengaluru, India

Abstract

Background It is estimated that approximately 1.5 to 17 of Indian pregnant women may have hyperglycemia. It is important to explore the feasibility of setting up a cohort of pregnant women to explore the adverse effect of hyperglycemia in their offspring.Objective The aim of this study was to explore the feasibility of recruiting cohort of pregnant women and administering Oral glucose tolerance tests OGTT in public health facilities of Bengaluru city. The study also aimed to ascertain the logistic requirements infrastructure and support system required to conduct and carry out a similar designed study for a longer period of time.Methodology Based on the published protocol pregnant women visiting the antenatal clinic at two public hospitals in Bengaluru were recruited as part of the pilot cohort study. The feasibility of recruiting performing the OGTT and follow ups was estimated in this study. As part of recruitment we assessed feasibility of administering a baseline questionnaire around 24 weeks of gestation along with anthropometric measurements. Subsequently we assessed the feasibility of conducting Oral glucose tolerance test OGTT in them which involved collecting fasting and two-hour postprandial blood samples after ingesting 75-gram glucose. The follow-ups were scheduled after delivery and during the immunization visits for the children. The feasibility of obtaining of reliable measurements of infants weight height and skin fold thickness was estimated at each follow-up visit.Results Of the 1243 women who were approached a cohort of 964 pregnant women was recruited. Among them 864pregnant women 90 did undergo oral glucose tolerance test and 840 women completed the test. The study identified several logistic and administrative challenges in conducting the OGTT and in following up the cohort. Among the 840 only 34740 women were available for follow-up at birth with abysmally low proportion of them voluntarily visiting for immunization visits.Conclusion Our study found that it is feasible to recruit administer OGTT to large number of pregnant women in setting up a birth cohort in public health facilities. For successful follow-up use of reminders and other motivation methods may improve the successful completion follow-ups in public health-facilities.nbsp