Yusof, Yusmawati Mohd
(2007)
Screening for gestational diabetes mellitus and associated risk factors before 20 weeks of g est ation in health clinics,
Tanah merah,Kelantan.
Masters thesis, Universiti Sains Malaysia.
Abstract
Screening for Gestational Diabetes Mellitus and Associated Risk Factors Before 20
Weeks of Gestation in Health Clinics, Tanah Merah, Kelantan.
Early diagnosis and treatment is the most important issue for the successful management
of gestational diabetes mellitus. Thus lays the importance of screening for gestational
diabetes mellitus, which allows for early initiation of appropriate therapy which remains
the cornerstone of management of gestational diabetes mellitus. The objectives of this
study were to determine the incidence of gestational diabetes mellitus before 20 weeks, at
24-28 weeks and at 32-34 weeks of gestation and to evaluate factors associated with
gestational diabetes mellitus before 20 weeks of gestation.
This is a cross sectional study. A total of 376 pregnant women started their antenatal care
at health clinics Tanah Merah, Kelantan before 20 weeks of gestation and were at risk of
developing gestational diabetes mellitus were enrolled. All pregnant women had initial
two hours 75-g oral glucose tolerance test before 20 weeks of gestation. If the results
were negative, second OGTT were performed at 24-28 weeks and subsequently at 32-34
weeks if still negative. A diagnosis of gestational diabetes mellitus was made if fasting
glucose ~ 6.1 mmol/l or 2 hours ~ 7.8 mmoi/l. The main outcome measures were
incidences of gestational diabetes mellitus before 20 weeks, at 24-28 and at 32-34 weeks
of gestation and the association between clinical risk factors and gestational diabetes
mellitus below 20 weeks of gestation. Data was analyzed using SPSS version 12.0. The
results sho\ved that the overall incidence of gestational diabetes mellitus was 47.9 %. The
incidence of GDM before 20 weeks of gestation was 33.0 %, another 13.5 % were
diagnosed between 24-28 weeks and 10.1 % between 32-34 weeks. The three independent
risks for developing gestational diabetes mellitus before 20 weeks of gestation were age ~
35 years, history of gestational diabetes mellitus in previous pregnancy and family history
of diabetes mellitus.
In conclusion, screening for gestational diabetes mellitus in Tanah Merah, Kelantan is
crucial in detecting early onset of gestational diabetes mellitus since nl0re than half of
women with gestational diabetes mellitus ( 124 of 180 , 68.9%) \vere diagnosed early in
their pregnancies. The three specific groups of women ( women age ~ 35 years, women
who had gestational diabetes mellitus in previous pregnancy and women with family
history of diabetes mellitus) should be promptly identified, counseled regarding the
important of early booking and early screening for gestational diabetes mellitus.
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