Prevalence of Gestational Diabetes Diagnosed before 24 Weeks of Gestation

Main Article Content

Kankamon Prasit
Dittakarn Boriboonhirunsarn

Abstract

Objectives: To determine prevalence of gestational diabetes (GDM) diagnosed before 24 weeks of gestation (Early GDM), to evaluate associated risk factors, and to compare pregnancy outcomes between different GDM status.
Materials and Methods: A total of 480 women who started antenatal care before 24 weeks of gestation were included. All women received a universal 2-step approach for GDM screening and diagnosis during first antenatal care visit and repeat at 24-28 weeks of gestation. Data were extracted from medical records, including baseline, obstetric and antenatal care data, GDM risks, diagnosis of GDM, and pregnancy outcomes. Prevalence of overall GDM, early and late GDM were estimated. Various characteristics and pregnancy outcomes were compared between women without GDM, early, and late GDM.
Results: Overall prevalence of GDM was 20%. Majority of GDM were diagnosed before 24 weeks of gestation (Early GDM) with the prevalence of 14.4% which contributed to 71.9% of all GDM cases. Both early and late GDM were more likely to be overweight and have previous GDM. Early GDM significantly had lower gestational weight gain than those without GDM. Rates of large for gestational age (LGA) and macrosomia were slightly higher in GDM women than those without GDM. The only significant risk factor for early GDM was previous GDM with adjusted OR 5.38, 95%CI 1.16-24.92 (p=0.031).
Conclusion: Prevalence of early GDM was 14.4% which contributed to 71.9% of all GDM cases. Pregnancy outcomes were not significantly different between early, late GDM and those without GDM. The only independent associated factor was previous GDM.

Article Details

How to Cite
(1)
Prasit, K. .; Boriboonhirunsarn, D. . Prevalence of Gestational Diabetes Diagnosed before 24 Weeks of Gestation. Thai J Obstet Gynaecol 2022, 30, 423-431.
Section
Original Article

References

1. ACOG Practice Bulletin No. 190 Summary: Gestational Diabetes Mellitus. Obstet Gynecol. 2018;131(2):406-8.
2. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care. 2020;43(Supplement 1):s14-31.
3. Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, et al. The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet. 2015;131 Suppl 3:S173-211.
4. Boriboonhirunsarn D, Sunsaneevithayakul P, Pannin C, Wamuk T. Prevalence of early-onset GDM and associated risk factors in a university hospital in Thailand. J Obstet Gynaecol. 2021;41(6):915-9.
5. Boriboonhirunsarn D, Sunsaneevithayakul P, Nuchangrid M. Incidence of gestational diabetes mellitus diagnosed before 20 weeks of gestation. J Med Assoc Thai. 2004;87(9):1017-21.
6. Immanuel J, Simmons D. Screening and Treatment for Early-Onset Gestational Diabetes Mellitus: a Systematic Review and Meta-analysis. Curr Diab Rep. 2017;17(11):115.
7. Bartha JL, Martinez-Del-Fresno P, Comino-Delgado R. Gestational diabetes mellitus diagnosed during early pregnancy. Am J Obstet Gynecol. 2000;182(2):346-50.
8. Bashir M, Baagar K, Naem E, Elkhatib F, Alshaybani N, Konje JC, et al. Pregnancy outcomes of early detected gestational diabetes: a retrospective comparison cohort study, Qatar. BMJ Open. 2019;9(2):e023612.
9. Hosseini E, Janghorbani M, Shahshahan Z. Comparison of risk factors and pregnancy outcomes of gestational diabetes mellitus diagnosed during early and late pregnancy. Midwifery. 2018;66:64-9.
10. Sweeting AN, Ross GP, Hyett J, Molyneaux L, Constantino M, Harding AJ, et al. Gestational Diabetes Mellitus in Early Pregnancy: Evidence for Poor Pregnancy Outcomes Despite Treatment. Diabetes Care. 2016;39(1):75-81.
11. Boriboonhirunsarn D, Kasempipatchai V. Incidence of large for gestational age infants when gestational diabetes mellitus is diagnosed early and late in pregnancy. J Obstet Gynaecol Res. 2016;42(3):273-8.
12. Most OL, Kim JH, Arslan AA, Klauser C. Maternal and neonatal outcomes in early glucose tolerance testing in an obstetric population in New York city. J Perinat Med. 2009;37(2):114-7.
13. Usami T, Yokoyama M, Ueno M, Iwama N, Sagawa N, Kawano R, et al. Comparison of pregnancy outcomes between women with early-onset and late-onset gestational diabetes in a retrospective multi-institutional study in Japan. J Diabetes Investig. 2020;11(1):216-222.
14. Rasmussen KM, Yaktine AL, editors. Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: The National Academies Press; 2009.
15. Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and metaanalysis. BMC Pregnancy Childbirth. 2018;18(1):494.
16. Benhalima K, Van Crombrugge P, Moyson C, Verhaeghe J, Vandeginste S, Verlaenen H, et al. Risk factor screening for gestational diabetes mellitus based on the 2013 WHO criteria. Eur J Endocrinol. 2019;180(6):353-63.