Prevalence of Gestational Diabetes Mellitus in Eastern and Southeastern Asia: A Systematic Review and Meta-Analysis

Abstract

Aim: To review the prevalence of gestational diabetes mellitus (GDM) in Eastern and Southeastern Asia.

Methods: We systematically searched for observational studies on GDM prevalence from January 2000 to December 2016. Inclusion criteria were original English papers, with full texts published in peer-reviewed journals. The quality of included studies was evaluated using the guidelines of the National Health and Medical Research Council, Australia. Fixed effects and random effects models were used to estimate the summary prevalence of GDM and the corresponding 95% confidence intervals (CI).

Results: A total of 4415 papers were screened, and 48 studies with 63 GDM prevalence observations were included in the final review. The pooled prevalence of GDM was 10.1% (95% CI: 6.5%-15.7%), despite substantial variations across nations. The prevalence of GDM in lower- or upper-middle income countries was about 64% higher than in their high-income counterparts. Moreover, the one-step screening method was twice more likely to be used in diagnosing GDM when compared to the two-step screening procedure.

Conclusions: The prevalence of GDM in Eastern and Southeastern Asia was high and varied among and within countries. There is a need for international uniformity in screening strategies and diagnostic criteria for GDM.

Figure 1

PRISMA flow diagram of selected studies.

Figure 2

Forest plots presenting the prevalence of gestational diabetes for individual studies and the corresponding pooled prevalence for studies combined according to diagnostic criteria in Eastern and Southeastern Asia. Bars and diamonds indicate 95% confidence interval (CI). The size of each square corresponds to the weight of the study in the meta-analysis using the Der Simonian and Laird method. ADA: American Diabetes Association; CC: Carpenter-Coustan; IADPSG: International Association of the Diabetes and Pregnancy Study Groups; JSOG: Japan Society of Obstetrics and Gynecology; NDDG: National Diabetes Data Group; WHO: World Health Organization.