Universal screening of gestational diabetes mellitus in Upper Egypt: Prospective cohort study of the prevalence, risk factors, and short-term outcomes

Abstract

Background: Despite the high prevalence of diabetes mellitus in Egypt, the real prevalence and epidemiology of gestational diabetes mellitus (GDM) in Upper Egypt are still lacking. Objective: This study aims to determine the prevalence and risk factors of GDM among pregnant women in Upper Egypt and to evaluate the fetal and maternal outcomes of this disease. Methods: This prospective cohort study was conducted between July 2014 and July 2018. Universal screening for GDM among all pregnant women attending primary health care clinics was done using Diabetes in Pregnancy Study Group of India (DIPSI) criteria. Those with GDM were followed up until the end of purpureum. Maternal and fetal outcomes were recorded. Results: GDM was diagnosed in 956 out of 7141 pregnant women (13.4%). Previous history of GDM, macrosomic babies, and family history of diabetes were all significantly higher in GDM women (P<0.001 each). However, no definite risk factors were observed in about half of the GDM women. 29% of GDM women responded to medical nutrition therapy (MNT) alone. When the oral glucose tolerance test (OGTT) was repeated Postpartum, diagnosis of DM was established in 14.3% of the cohort, while 25.7% had impaired glucose tolerance. Conclusions: The prevalence of GDM is relatively high in Upper Egypt. Half of GDM cases lack risk factors. Universal screening using OGTT should be routinely performed on all attendant pregnant ladies. Discrete MNT is not enough management in most GDM cases.