Year: 2020
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: 1. Abstract 1.1. Background: Evidence suggests that diabetes in all forms are on the rise especially gesta-tional diabetes mellitus which increases the risk of maternal and neonatal morbidities; however global prevalence rates and geographical distribution of GDM remain uncertain. The aim of this study is to examine the global burden of gestational diabetes mellitus. 1.2. Methods: A systematic review and meta-analysis of studies reporting Randomised Clinical Trials (RCTs) in pregnant women who have GDM was conducted. Cochrane (Central), PubMed, Scopus, JBI, Medline, EMBASE and reference lists of retrieved studies were searched from inception to March 2019. Publications on prevalence of GDM irrespective of the baseline criteria used to diagnose GDM were included in the study. Studies were limited to English language, randomised control trials and women aged between 19-44 years inclusive. 1.3. Results: Eleven RCTs met the inclusion criteria for this review. The included studies collectively reported GDM rates of 13,450 pregnant women from 7 countries. The diagnostic criteria used in the studies were World Health Organisation (WHO) 1985 and 1999, International Association of Diabetes, Pregnancy Study Group (IADPSG), National Diabetes Data Group (NDDG), Carpenter-Coustan (C&C) and O'Sullivan's criteria. Seven RCTs screened for GDM in comparison with different diagnostic criteria in the same population while three studies used the same criteria for different groups. One study compared 100g, 3h OGTT to 75g, 2h OGTT for diagnosing GDM using Carpenter and Coustan criteria. All seven RCTs that compared different diagnostic criteria in the same population detected different prevalence rates of GDM. Three RCTs measured prevalence of GDM in the same population using WHO 1999 and IADPSG 2013 criteria. Using random effect model, data from three studies that compared IADPSG criteria to WHO 1999 showed an Odds Ratio (OR) of 0.52(0.15, 1.84), 95% Confidence Interval (CI) and high heterogeneity of 99%. In all three studies, prevalence of GDM measured by IADPSG criteria was higher than WHO 1999 criteria, although not significant (p= 0.31). Combining all the studies gave a global estimated prevalence of GDM to be 10.13% (95% CI, 7.33-12.94) with moderate heterogeneity of 27%. The highest prevalence of GDM with
Authors: Philemon Gyasi-Antwi, Liz Walker, C Moody, Seth Asare Okyere, K Salt, L. Anang, E. Eduful, Dennis Odai Laryea, D. Ottie-Boakye, Kwaku Asah‐Opoku, S. Asibey, Osei Sarfo‐Kantanka, E. Baffour-Agyei, Ian Shaw, Gary G. Adams
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3169952342