Risk factors for gestational diabetes mellitus: A prospective case-control study from coastal Karnataka

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Clinical Epidemiology and Global Health


Background: Identification of gestational diabetes mellitus (GDM) risk factors is pertinent, for it can be an effective intervention for its prevention. As previous information regarding GDM risk factors from India were mostly descriptive and scarce from coastal Karnataka, a current prospective case-control study was designed to identify GDM risk factors among pregnant women seeking antenatal care. Methods: A hospital-based prospective matched case–control study was carried among antenatal subjects seeking routine antenatal care at two secondary-level care private hospitals, affiliated to a University Medical College in coastal Karnataka. It comprised of 100 incident GDM cases and 273 frequency-matched controls. Data was collected by personal interviews using a pretested questionnaire. Data was entered and analyzed using Statistical Package for Social Sciences(SPSS), version 15.0. Results: Risk factors using Carpenter and Coustan criteria and DIPSI criteria were found similar. Pooled data identified following significant GDM risk factors: marital age (25–29 years)(adjusted OR:18.2; 95% CI:1.9–177.6; p= 0.012), delayed menarche (adjusted OR:11.4; 95% CI:1.1–124.6; p=0.045), multiparity (adjusted OR:14.1; 95% CI:1.8–109.8; p=0.011), family history of DM (adjusted OR:66.6; 95% CI:6.9–645.2; p < 0.001), high maternal perceived stress (adjusted OR:21.6; 95% CI:1.9–248.8; p=0.014, less physical activity (adjusted OR:21.0; 95% CI: 2.8–158.8; p=0.003), and low intake of green leafy vegetables (GLV)(adjusted OR:41.7; 95% CI:3.7–472.4; p=0.003). Positive current polyhydramnios and recurrent vaginal infections were also identified as significant risk factors (p<0.05). Conclusions: Modifiable risk factors identified were low physical activity, high antenatal perceived stress, multiparity, marital age ≥25 years, and low pre-pregnancy intake of GLV, which were also comparable using two criteria in vogue for GDM diagnosis. Pre-conception advice on healthy lifestyle may prove beneficial.

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