Prevalence of Abnormal Glucose Tolerance in Obese Pregnant Women - A Study from a Tertiary Care Centre

Abstract

BACKGROUND Obesity has emerged as an important risk factor in modern obstetrics and poses a major threat to pregnancy by causing complications including gestational diabetes. It also increases the risk of cardiovascular diseases and diabetes mellitus in later life. Obesity creates major technical challenges in providing maternity services too. The objective of the study was to assess the prevalence of abnormal glucose tolerance in obese pregnant women in a Government Medical College over one year. METHODS A prospective observational study was conducted among obese pregnant women, registered at the Outpatient department of Obstetrics and Gynaecology at the Government Medical College, Kottayam from January 2017 to December 2017. 450 women were considered for the study after satisfying inclusion and exclusion criteria. BMI was calculated using pre-pregnant weight. An oral glucose test was performed with 75 gm glucose at 24 to 28 weeks of pregnancy after 8 hours of fasting. International Association of Diabetes and Pregnancy Study Group cut-offs i.e., fasting blood sugar values more than 92 mg/dl, 1hr value more than 180 mg/dl, 2 hr value more than 153 mg/dl were used as the criteria. Oral glucose tolerance was considered abnormal if any of the above values were impaired. RESULTS The prevalence of abnormal glucose tolerance among the 450 pregnant women was 35.6 %. The incidence of abnormal GTT increased with increasing age and in those with a history of menstrual irregularities and infertility treatment. No relation was found between economic status, family history of diabetes, preeclampsia and abnormal GTT. CONCLUSIONS Obesity turns to be a menace in the reproductive life of women that begins by affecting the fertility, continues to cause complications in pregnancy, increases morbidity in the long-term future and reduces the quality of life. Since more than one-third of the study population was affected by gestational diabetes, active intervention to reduce the weight preconceptionally is needed. KEY WORDS Obesity, Glucose Tolerance Test, Gestational Diabetes Mellitus, Body Mass Index, Pregnancy