Philippine E-Journals

The Prevalence of Gestational Diabetes Mellitus Using the IADPSG Criteria and its Risk Factors Among Filipino Women in a Tertiary Hospital: A Single-Center Study

Bernadette L. Dela Cruz | Marjorie A. Santos

Discipline: medicine (non-specific)

 

Abstract:

Background: The worldwide prevalence of gestational diabetes mellitus (GDM) vary from <1 to 28% depending on the race, country and diagnostic criteria used. The Philippine Obstetrical and Gynecological Society (POGS) endorses the IADPSG criteria which places the prevalence rate of pregnant Filipino women as high as 29.27%. Filipino women are predisposed to GDM due to multiple factors. Identifying these risk factors will improve pregnancy outcome and prevent long-term complications. Objective: To determine the prevalence of GDM in Filipino women and its associated risk factors, which includes establishing risk assessment system and comparing pregnancy outcome of women with and without GDM. Methods: This is a retrospective study that involved 120 Filipino women who had their prenatal check-up and delivery in MCU OB Clinical Division. GDM was diagnosed using the IADPSG criteria and the prevalence was computed. Results were compared to determine risk factors associated with GDM. Results: The prevalence of GDM in MCU OB Clinical Division from 2018 to 2021 ranged from 6.5% to 19.8%. There was a significant difference between the 75g OGTT results of women with and without GDM with a p < 0.001. Modifiable and nonmodifiable risk factors revealed women who later develop GDM were older (p = 0.007), had greater pre-pregnancy weight (p < .001) and higher BMI (p < .001) than those without GDM. They also have history of PCOS (p = .045) and a family history of DM (p < .001). Women with past history of GDM were more likely to develop GDM on succeeding pregnancies (p < 0.001). Women with GDM were heavier during admission (p < .001). However, there was no significant difference between the weight gain of women with and without GDM (p = .480). Pregnancy outcome was compared and majority of women with GDM delivered by primary cesarean section (25.9%) and assisted vaginal delivery (25.9%). There was no significant difference between the incidence of large for gestational age and fetal macrosomia in women with and without GDM with a p- value of 0.637 and 0.401, respectively. Conclusions: The overall prevalence of GDM was 16.7% from 2018 to 2021 with the prevalence (6.5%) noted in 2020 during the COVID-19 Pandemic due to the closure of the OPD. In this study, the identified risk factors for GDM were older (32 ± 4.993), had greater pre-pregnancy weight (66.556 ± 7.949), higher BMI (26.596 ± 3.036), history of PCOS, family history of diabetes and weigh more during admission (75.685 ± 8.935) than those without GDM. Although, majority of women with GDM underwent cesarean delivery (25.9%) and assisted vaginal delivery (25.9%), there were no other significant difference between the outcomes of women with and without GDM.