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Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis.
BMC Pregnancy Childbirth 2018; 18(1):494BP

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis.

METHODS

We systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI).

RESULTS

Eighty-four studies with STROBE score ≥ 14 were included in our analysis. The pooled prevalence of GDM in Asia was 11.5% (95% CI 10.9-12.1). There was considerable heterogeneity (I2 > 95%) in the prevalence of GDM in Asia, which is likely due to differences in diagnostic criteria, screening methods and study setting. Meta-analysis demonstrated that the risk factors of GDM include history of previous GDM (OR 8.42, 95% CI 5.35-13.23); macrosomia (OR 4.41, 95% CI 3.09-6.31); and congenital anomalies (OR 4.25, 95% CI 1.52-11.88). Other risk factors include a BMI ≥25 kg/m2 (OR 3.27, 95% CI 2.81-3.80); pregnancy-induced hypertension (OR 3.20, 95% CI 2.19-4.68); family history of diabetes (OR 2.77, 2.22-3.47); history of stillbirth (OR 2.39, 95% CI 1.68-3.40); polycystic ovary syndrome (OR 2.33, 95% CI1.72-3.17); history of abortion (OR 2.25, 95% CI 1.54-3.29); age ≥ 25 (OR 2.17, 95% CI 1.96-2.41); multiparity ≥2 (OR 1.37, 95% CI 1.24-1.52); and history of preterm delivery (OR 1.93, 95% CI 1.21-3.07).

CONCLUSION

We found a high prevalence of GDM among the Asian population. Asian women with common risk factors especially among those with history of previous GDM, congenital anomalies or macrosomia should receive additional attention from physician as high-risk cases for GDM in pregnancy.

TRIAL REGISTRATION

PROSPERO (2017: CRD42017070104).

Authors+Show Affiliations

Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia. sm_ching@upm.edu.my. Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400, Serdang, Malaysia. sm_ching@upm.edu.my.Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400, Serdang, Malaysia.Department of Psychological Medicine, University of Malaya Center for Addiction Sciences (UMCAS), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, 47500, Bandar Sunway, Selangor, Malaysia.Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.Department of Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.Department of Pharmacy Practice, School of Pharmacy, International Medical University, 57000, Kuala Lumpur, Malaysia.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

30547769

Citation

Lee, Kai Wei, et al. "Prevalence and Risk Factors of Gestational Diabetes Mellitus in Asia: a Systematic Review and Meta-analysis." BMC Pregnancy and Childbirth, vol. 18, no. 1, 2018, p. 494.
Lee KW, Ching SM, Ramachandran V, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2018;18(1):494.
Lee, K. W., Ching, S. M., Ramachandran, V., Yee, A., Hoo, F. K., Chia, Y. C., ... Veettil, S. K. (2018). Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy and Childbirth, 18(1), p. 494. doi:10.1186/s12884-018-2131-4.
Lee KW, et al. Prevalence and Risk Factors of Gestational Diabetes Mellitus in Asia: a Systematic Review and Meta-analysis. BMC Pregnancy Childbirth. 2018 Dec 14;18(1):494. PubMed PMID: 30547769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. AU - Lee,Kai Wei, AU - Ching,Siew Mooi, AU - Ramachandran,Vasudevan, AU - Yee,Anne, AU - Hoo,Fan Kee, AU - Chia,Yook Chin, AU - Wan Sulaiman,Wan Aliaa, AU - Suppiah,Subapriya, AU - Mohamed,Mohd Hazmi, AU - Veettil,Sajesh K, Y1 - 2018/12/14/ PY - 2018/06/23/received PY - 2018/11/30/accepted PY - 2018/12/15/entrez PY - 2018/12/15/pubmed PY - 2019/4/6/medline KW - Asia; meta-analysis KW - Gestational diabetes mellitus KW - Prevalence KW - Risk factors SP - 494 EP - 494 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 18 IS - 1 N2 - BACKGROUND: Gestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis. METHODS: We systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI). RESULTS: Eighty-four studies with STROBE score ≥ 14 were included in our analysis. The pooled prevalence of GDM in Asia was 11.5% (95% CI 10.9-12.1). There was considerable heterogeneity (I2 > 95%) in the prevalence of GDM in Asia, which is likely due to differences in diagnostic criteria, screening methods and study setting. Meta-analysis demonstrated that the risk factors of GDM include history of previous GDM (OR 8.42, 95% CI 5.35-13.23); macrosomia (OR 4.41, 95% CI 3.09-6.31); and congenital anomalies (OR 4.25, 95% CI 1.52-11.88). Other risk factors include a BMI ≥25 kg/m2 (OR 3.27, 95% CI 2.81-3.80); pregnancy-induced hypertension (OR 3.20, 95% CI 2.19-4.68); family history of diabetes (OR 2.77, 2.22-3.47); history of stillbirth (OR 2.39, 95% CI 1.68-3.40); polycystic ovary syndrome (OR 2.33, 95% CI1.72-3.17); history of abortion (OR 2.25, 95% CI 1.54-3.29); age ≥ 25 (OR 2.17, 95% CI 1.96-2.41); multiparity ≥2 (OR 1.37, 95% CI 1.24-1.52); and history of preterm delivery (OR 1.93, 95% CI 1.21-3.07). CONCLUSION: We found a high prevalence of GDM among the Asian population. Asian women with common risk factors especially among those with history of previous GDM, congenital anomalies or macrosomia should receive additional attention from physician as high-risk cases for GDM in pregnancy. TRIAL REGISTRATION: PROSPERO (2017: CRD42017070104). SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/30547769/Prevalence_and_risk_factors_of_gestational_diabetes_mellitus_in_Asia:_a_systematic_review_and_meta_analysis_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-2131-4 DB - PRIME DP - Unbound Medicine ER -