Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India

• Published in: PloS one Vol. 11; no. 3; p. e0151311
• Main Authors: Kragelund Nielsen, Karoline, Damm, Peter, Kapur, Anil, Balaji, Vijayam, Balaji, Madhuri S, Seshiah, Veerasamy, Bygbjerg, Ib C
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18.03.2016; Public Library of Science (PLoS)
• Subjects: Adult; Body mass; Body Mass Index; Demographic aspects; Diabetes; Diabetes mellitus; Diseases and pests; Education; Female; Follow-Up Studies; Glucose tolerance; Glucose Tolerance Test; Health aspects; Health care facilities; Health centres; Health facilities; Health risk assessment; Health risks; Hip; Humans; Hyperglycemia; Hyperglycemia - diagnosis; Hyperglycemia - epidemiology; Hyperglycemia - ethnology; India - epidemiology; India - ethnology; Low income groups; Mathematical analysis; Medical screening; Medicine and Health Sciences; Older people; Parents; Population; Population studies; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - epidemiology; Pregnancy Complications - ethnology; Pregnant women; Prognosis; Public health; Regression analysis; Risk analysis; Risk Factors; Scoring; Screening; Sensitivity analysis; Social Sciences; Socioeconomic factors; Studies; Systematic review; Womens health; India; Denmark; Tamil Nadu India
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0151311

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. 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. 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. 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. 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.