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Prevalence of Gestational Diabetes and Its Association With Stillbirth, Preterm Birth, Macrosomia, Abortion and Cesarean Delivery: A National Prevalence Study of 11 Provinces in Iran Publisher Pubmed



Darbandi M1 ; Rezaeian S2, 3 ; Dianatinasab M4 ; Yaghoobi H5 ; Soltani M6 ; Etemad K7 ; Valadbeigi T8 ; Taherpour N9 ; Hajipour M10 ; Saeidi R11
Authors
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Authors Affiliations
  1. 1. Student Research Committee, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
  2. 2. Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  3. 3. Research Centerfor Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
  4. 4. Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
  5. 5. Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
  6. 6. Razi Clinical Research Development Unit (RCRDU), Birjand University of Medical Sciences(BUMS), Birjand, Iran
  7. 7. Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  8. 8. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  10. 10. Pediatric Gastroentrology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical sciences, Tehran, Iran
  11. 11. Neonatal Health Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Journal of Preventive Medicine and Hygiene Published:2021


Abstract

Background. Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders during pregnancy that significantly affects perinatal outcomes. Objective. The aim of this study was to determine the prevalence of GDM and its relation with the incidence of stillbirth, preterm birth, macrosomia, abortion and cesarean section (C-section) delivery in pregnant women. Methods. This cross-sectional study was conducted on 3675 pregnant women in 11 provinces across Iran. Cluster sampling was used to select samples from mothers covered by health plans in 11 provinces of Iran. Prevalence of adverse pregnancy outcomes, including preterm delivery, type of delivery, macrosomic preterm birth, miscarriage, stillbirth, infant death, and birth weight were measured, using family record and face-to-face interviews. Data were analyzed by logistic regression, using STATA14.2 software. Results. About four percent of Iranian pregnant women had GDM during pregnancy. Prevalence of C-section was significantly higher in diabetic women than in the non-diabetic ones (53.19 vs 46.81, respectively, P < 0.001). Abortion in diabetic mothers was more than twice that of the non-diabetic mothers (P < 0.001). In the adjusted logistic regression model, the odds of stillbirth in mothers with GDM were 1.8 (95% CI: 1.11, 2.91, P = 0.018) times higher than that of the non-diabetics. The odds of macrosomia in diabetic women was about 7 times higher than the non-diabetic women (95% CI: 2.81, 17.14, P < 0.001). The odds of GDM had an increasing trend according to the BMI (p < 0.001). The risk of GDM were significantly lower, according to the daily physical activity (PA) (p < 0.001). Conclusion. The GDM prevalence has a decreasing trend in Iran. It increases the adverse pregnancy outcomes such as stillbirth, neonatal deaths, macrosomia, preterm birth, abortion and C-section delivery. As, some of these consequences like macrosomia are not treatable, thus early prevention is very crucial. © by Pacini Editore Srl
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