Prevalence and Determinants of Gestational Diabetes Mellitus(GDM) in urban Chattogram: A Hospital-based study

Abstract

Background Gestational Diabetes Mellitus(GDM), one of the critical complications during pregnancy, poses detrimental consequences on both maternal and child health. Worldwide almost 14% of pregnancies get affected by GDM and the scenario in Bangladesh is no exception here. In Bangladesh, where the non-communicable disease rate is rising, GDM poses a major public health challenge fueled by factors like poor coverage of antenatal service, socio-economic disparities,, sedentary lifestyle and limited physical activity. GDM causes consequences like- gestational hypertension, termination of the pregnancy through C-section, preeclampsia, high birth weight baby. Moreover, post delivery there remains the chance of developing impairment of carbohydrate metabolism, obesity, Type-2 Diabetes Mellitus, cardiovascular disease development among mother and infants. Not only physical complications, it also comes with a significant economic burden on families and the health care system. which needs greater attention and awareness. Therefore, this hospital based cross-sectional study aims to determine the prevalence and determinants of Gestational Diabetes Mellitus in urban chattogram through a hospital based cross sectional study, providing crucial insights for targeted interventions and improved maternal healthcare.

Methodology A cross-sectional study design was implemented using structured questionnaire to collect the numerical data to estimate the prevalence of GDM, and its determinant factors including socio demographic condition, lifestyle factors, previous maternal history and Adverse Childhood Experiences(ACEs), among the pregnant women of urban Chattogram. There were usage of multiple tools to assess the determinant factors. A total of 200 pregnant women in their second & third trimester visiting for their routine antenatal checkups in hospitals were chosen for the study. It was mandatory for the selected pregnant women to have the biochemistry report of Fasting Blood Sugar(FBS) and 2 hrs after 75 gm glucose/2 hrs after breakfast(2HABF). Hospitals were selected purposively as they are reputed hospitals, and the participants were selected through simple random sampling. Further, using the SPSS software, the collected information was analysed to determine the prevalence and determinants of GDM. Result The sociodemographic features were- maximum participants 76(38.0%) were from the age group 22-26, almost half(49.5%) of them have completed secondary education, and quarter (25%) of them have completed Primary Education. Largest portion 49(24.5%) of monthly household income was more than 35000 taka, and the lowest portion 26(13%) of household income ranged between (25002 to 35002) taka. This study found a 16% prevalence of Gestational Diabetes Mellitus (GDM) in the urban Chattogram population explored. Maternal age was a key predictor, with 34.4% of GDM cases occurring in women aged 27-31 years. Notably, 87.5% of women with GDM reported eating insufficient vegetables, indicating a substantial dietary risk factor. Furthermore, 12.5% of GDM cases had a history of GDM in previous pregnancies, 31.1% had undergone an abortion, and an astonishing 40.6% of women had GDM with severe Adverse Childhood Experiences (ACEs) before the age of 18 were diagnosed. These findings highlight the crucial need for targeted public health initiatives. Addressing public health interventions focused on promoting healthy dietary habits, raising awareness about GDM risk factors, and providing accessible mental health services for women with a history of ACEs.

Conclusion In this study, the prevalence and determinants of Gestational Diabetes Mellitus(GDM) were studied in the urban chattogram through cross-sectional study. The prevalence rate of GDM in this study was 16% and critical factors contributing to this prevalence include- maternal age, history of GDM and abortion, poor intake of vegetables and adverse childhood experiences. To cure this situation, addressing system-level public health strategies that integrate nutritional education, GDM risk awareness campaigns, and accessible mental health services within existing maternal healthcare frameworks is recommended.