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Published on: April 23, 2018
Gestational diabetes mellitus--screening in a developing country
N Samad1, J A Hassan, A S Shera
1Department of Obstetrics and Gynaecology, Dow Medical College and Civil Hospital, Karachi.
JPMA. the Journal of the Pakistan Medical Association
|November 1, 1996
Summary
Screening pregnant women for diabetes mellitus (DM) is crucial. High-risk pregnancies showed significantly higher DM rates, suggesting targeted screening may be effective when resources are limited.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Diabetes mellitus (DM) poses significant risks during pregnancy.
- Identifying pregnant women at risk for DM is essential for timely intervention.
- Previous studies have explored risk factors for gestational diabetes.
Purpose of the Study:
- To determine the prevalence of diabetes mellitus in pregnant women based on risk factors.
- To compare DM detection rates between high-risk and low-risk pregnant populations.
- To evaluate the effectiveness of risk factor-based screening for gestational diabetes.
Main Methods:
- A prospective study included gravid women from antenatal clinics and unbooked labor admissions (October 1986-December 1993).
- Women were categorized into three groups based on DM risk factors: Group-I (multiple risk factors), Group-II (pregnancy-induced hypertension, advanced maternal age, etc.), and Group-III (no risk factors).
- Screening utilized the O'Sullivan criteria, with diagnoses confirmed for diabetes mellitus.
Main Results:
- Out of 4497 antenatal subjects, DM was diagnosed in 12% (Group-I), 3% (Group-II), and 0.6% (Group-III).
- Among 7600 non-booked admissions, DM was detected in 20% of high-risk (Groups-I & II) versus 0.6% in Group-III.
- Chi-square analysis confirmed significantly higher DM frequency in Group-I and Group-II compared to Group-III (P < 0.001).
Conclusions:
- Universal screening for diabetes mellitus in all pregnant women is recommended.
- Targeted screening of high-risk pregnancies is a viable alternative when financial constraints exist.
- Risk factor stratification effectively identifies pregnant women with a higher likelihood of diabetes mellitus.
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