Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Association of gestational hyperglycemia with adverse maternal outcomes: Results from the MAASTHI birth cohort in Bangalore, South India
Giridhara R Babu

Last modified: 2018-08-20


Background: Earlier studies suggest that the prevalence of gestational diabetes mellitus (GDM) in India rangesfrom 0.6% to 27.3%. Despite the possibility of having high prevalence, screening for GDM in pregnant women is ineffective in most of the public hospitals. Also, there is limited knowledge on adverse effects of GDM in mothers and neonates in India’s public hospitals.

Materials and methods: A prospective cohort study was conducted in an antenatal clinic of a secondary level public hospital in Urban Bangalore. After assessment of eligibility criteria and obtaining informed voluntary consent, the research staff assessed the pregnant women for baseline characteristics. Also, we recorded blood pressure and anthropometric measurements. Thepregnant women in the study population underwent a 75-gram oral glucose tolerance test (OGTT) after 24 weeks of gestational age. Also,Edinburgh Postnatal Depression Scale (EPDS) was used to assess mental distress in mothers. Follow-up of mothers and neonates wasdone soon after delivery,wherein anthropometry and other health related information was sought.


Results:We found that 15% of the pregnant women in the study population had GDM. The odds of having hypertension was nearly 1.6 times higher in women with GDM (OR: 2.63, 95% CI 1.32-5.22)compared to women without GDM.The odds of having caesarian section was 80% higher (OR:1.80, 95% CI 1.11-2.93) in the women with GDM. Women with symptoms suggestive of mental distress (EPDS score>11) had 75% higher odds of having GDM (OR: 1.75; 95% CI 1.14-2.67)compared to women without GDM, after adjusting for gravida, parity, age and family history.


Conclusions : Wefound that women in the public hospitals have higher risk of having GDM. Also, our study indicates that women with GDM have higher odds of having gestational hypertension, caesarian section, and coexisting symptoms of mental distress. It is important to screen all the pregnant women attending public hospitals for GDM in public hospitals.


Acknowledgements: This work was supported by the Wellcome Trust/DBT India Alliance Fellowship [grant number  IA/CPHI/14/1/501499] awarded to Dr. Giridhara R Babu


Keywords:  Gestational diabetes, adverse effects of GDM, Birth cohort, GDM screening, High-risk pregnancy, Noncommunicable diseases.