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Clinical Trial
. 2016 Mar 18;11(3):e0151311.
doi: 10.1371/journal.pone.0151311. eCollection 2016.

Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India

Karoline Kragelund Nielsen  1   2 , Peter Damm  3   4 , Anil Kapur  2 , Vijayam Balaji  5 , Madhuri S Balaji  5 , Veerasamy Seshiah  5 , Ib C Bygbjerg  1
Affiliations
Clinical Trial

Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India

Karoline Kragelund Nielsen et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The study is being financially supported by the World Diabetes Foundation, which receives unrestricted grants from Novo Nordisk A/S. AK is the chairman of World Diabetes Foundation and holds shares in Novo Nordisk A/S. VB, MSB, VS and AK are members of the executive board of the Diabetes in Pregnancy Study Group India. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Distribution of risk factors according to hyperglycaemic status among pregnant women, n = 3377†.
† Only subjects with data on all three risk factors included.
See this image and copyright information in PMC

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