Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units

Abstract

ObjectiveTo determine the prevalence and predictors of gestational diabetes mellitus (GDM) in rural Assam, India using a network of Mobile Medical Units.Study designA field-based cross-sectional study.SettingsRural areas of Assam state, India.ParticipantsA total of 1410 pregnant women in gestational age of 24–28 weeksInterventionIdentification of pregnant women in 24–28 weeks of pregnancy from villages and administering them Government of India recommended oral glucose tolerance test for GDM confirmation.Primary and secondary outcome measuresPresence of gestational diabetes among pregnant women, risk factors and predictors of GDM.ResultsA total of 1212 pregnant women underwent the oral glucose tolerance test. One hundred and ninety-eight women were ineligible due to existing chronic diseases or very high blood glucose level before the test. The overall GDM prevalence in Assam was 16.67% (95% CI 14.61% to 18.89%). Women aged 26–30 years (adjusted odds ratio, aOR 1.70; CI 1.14 to 2.52), who passed 10th class (aOR 1.58; CI 1.05 to 2.37), belonging to Muslim religion (aOR 1.52; 95% CI 1.05 to 2.21) and above poverty line (aOR 1.38; 95% CI 1.00 to 1.91) had significantly increased likelihood of developing GDM compared with respective baseline groups (p<0.05). Body mass index, gravida and being non-anaemic were non-significant risk factors for GDM. Family history of diabetes (aOR 1.82; 95% CI 1.08 to 3.06) and smoking (aOR 1.61; 95% CI 1.10 to 2.35) were significant and independent predictors of GDM.ConclusionThe prevalence of GDM in rural Assam is high. The mobile medical units may play a significant role in the implementation of GDM screening, diagnosis, treatment to ensure better maternal and foetal health outcomes in rural Assam.