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Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India

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  • Karoline Kragelund Nielsen
  • Peter Damm
  • Anil Kapur
  • Vijayam Balaji
  • Madhuri S Balaji
  • Veerasamy Seshiah
  • Ib C Bygbjerg

Abstract

Introduction: Hyperglycaemia in pregnancy (HIP), i.e. gestational diabetes mellitus (GDM) and diabetes in pregnancy (DIP), increases the risk of various short- and long-term adverse outcomes. However, much remains to be understood about the role of different risk factors in development of HIP. Objective: The aims of this observational study were to examine the role of potential risk factors for HIP, and to investigate whether any single or accumulated risk factor(s) could be used to predict HIP among women attending GDM screening at three centres in urban, semi-urban and rural Tamil Nadu, India. Methodology: Pregnant women underwent a 75 g oral glucose tolerance test. Data on potential risk factors was collected and analysed using logistical regression analysis. Receiver operating characteristic (ROC) curves, sensitivity, specificity and predictive values were calculated for significant risk factors and a risk factor scoring variable was constructed. Results: HIP was prevalent in 18.9% of the study population (16.3% GDM; 2.6% DIP). Increasing age and BMI as well as having a mother only or both parents with diabetes were significant independent risk factors for HIP. Among women attending the rural health centre a doubling of income corresponded to an 80% increased risk of HIP (OR 1.80, 95%CI 1.10–2.93; p = 0.019), whereas it was not significantly associated with HIP among women attending the other health centres. The performance of the individual risk factors and the constructed scoring variable differed substantially between the three health centres, but none of them were good enough to discriminate between those with and without HIP. Conclusions: The findings highlight the importance of socio-economic circumstances and intergenerational risk transmission in the occurrence of HIP as well as the need for universal screening.

Suggested Citation

  • Karoline Kragelund Nielsen & Peter Damm & Anil Kapur & Vijayam Balaji & Madhuri S Balaji & Veerasamy Seshiah & Ib C Bygbjerg, 2016. "Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-18, March.
  • Handle: RePEc:plo:pone00:0151311
    DOI: 10.1371/journal.pone.0151311
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    References listed on IDEAS

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    1. Robbins, J.M. & Vaccarino, V. & Zhang, H. & Kasl, S.V., 2001. "Socioeconomic status and type 2 diabetes in African American and non-Hispanic White women and men: Evidence from the Third National Health and Nutrition Examination Survey," American Journal of Public Health, American Public Health Association, vol. 91(1), pages 76-83.
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    1. Diane Farrar & Mark Simmonds & Maria Bryant & Debbie A Lawlor & Fidelma Dunne & Derek Tuffnell & Trevor A Sheldon, 2017. "Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-17, April.
    2. Karoline Kragelund Nielsen & Thilde Vildekilde & Anil Kapur & Peter Damm & Veerasamy Seshiah & Ib C. Bygbjerg, 2020. "“If I Don’t Eat Enough, I Won’t Be Healthy”. Women’s Experiences with Gestational Diabetes Mellitus Treatment in Rural and Urban South India," IJERPH, MDPI, vol. 17(9), pages 1-19, April.

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