Prevalence and risk factors of gestational diabetes mellitus: findings from a universal screening feasibility program in Lima, Peru

Gloria T Larrabure-Torrealva,Walter Castillo,Hugo Ingar,Mirtha Grande,Pedro A Mascaro,Percy Pacora,Miguel Angel Luque-Fernandez,Vicky Motta,Michelle A Williams,Sixto E Sanchez,Rina Zumaeta,Stephanie Martinez,Bizu Gelaye

doi:10.1186/s12884-018-1904-0

Abstract

BackgroundGestational diabetes mellitus (GDM) is a global public health concern with potential implications for the health of a mother and her offspring. However, data on the prevalence and risk factors of GDM in Latin America are scarce.The study was designed to estimate the prevalence of GDM and identify maternal risk factors among Peruvian women.MethodsA cross-sectional study was conducted among 1300 pregnant women attending a prenatal clinic in Lima, Peru. GDM was diagnosed using an Oral Glucose Tolerance Test (OGTT) performed between 24 and 28 gestational weeks using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Depression status was assessed using the Patient Health Questionnaire-9. Multivariate logistic regression models were used to identify risk factors of GDM.ResultsApproximately 16% of pregnant women were diagnosed with GDM. The prevalence of obesity and depression were 24.4 and 10.6%, respectively. After adjusting for confounders, mid-pregnancy obesity was associated with a 1.64-fold increased odds of GDM (OR: 1.64; 95% CI: 1.03–2.61). Participants with a family history of diabetes had a 1.5-fold increased odds of developing GDM (OR: 1.51, 95% CI: 1.10–2.07) as compared to women without this family history. Depression was associated with a 1.54-fold increased odds of GDM (OR: 1.54; 95% CI:1.09–2.17).ConclusionsGDM is highly prevalent and was associated with maternal obesity, family history of diabetes and antepartum depression among Peruvian women. Intervention programs aimed at early diagnoses and management of GDM need to take maternal obesity, family history of diabetes and antepartum depression into account.

Highlights

Gestational diabetes mellitus (GDM) is a global public health concern with potential implications for the health of a mother and her offspring
Study population The Screening Treatment and Effective Management of Gestational Diabetes Mellitus (STEM-GDM) was designed to evaluate the prevalence of GDM among Peruvian women attending perinatal care and to provide evidence to improve the local guidelines for standardized GDM screening/diagnosis, effective management, and treatment
To the best of our knowledge, this is the first study to examine the prevalence of GDM in Lima, Peru using the IADPSG criteria, as well as the presence of family history of diabetes mellitus, maternal mid-pregnancy obesity, and maternal depression as independent risk factors of GDM

Summary

Introduction

Gestational diabetes mellitus (GDM) is a global public health concern with potential implications for the health of a mother and her offspring. Data on the prevalence and risk factors of GDM in Latin America are scarce. The study was designed to estimate the prevalence of GDM and identify maternal risk factors among Peruvian women. In the United States, recent estimates show up to 9% of all pregnancies are complicated by GDM [3]. Obesity and a family history of diabetes have been consistently identified as major risk factors for GDM in previous studies [3]. Significant neonatal complications have been associated with obesity and GDM. These include congenital anomalies [20, 21], macrosomia [22], and birth injury [23, 24]. An expanding body of evidence implicates unipolar major depressive disorder as one of the major risk factors for and conditions co-occurring with GDM [25], the evidence is inconsistent [26]

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