Exploring the prevalence of gestational diabetes mellitus and associated factors among pregnant women attending tertiary antenatal hospitals in Bangladesh: a cross-sectional survey-based approach.

Abstract

Gestational diabetes mellitus (GDM) is a form of hyperglycemia which is first diagnosed during pregnancy. South Asian women show a higher prevalence of GDM, which has been associated with both genetic and lifestyle factors. This survey-based cross-sectional study aimed to estimate the prevalence of GDM among pregnant women attending tertiary healthcare facilities for antenatal care and to identify factors independently associated with GDM. A total of 250 pregnant women at 18-40 weeks of gestation attending tertiary healthcare facilities in the Dhaka, Chattogram, and Mymensingh divisions were selected using a non-probability consecutive sampling approach. Data were collected using a structured questionnaire covering demographic, obstetric, clinical, and lifestyle factors after obtaining informed consent from all participants. GDM status was determined based on a one-step 75 g OGTT test in accordance with national and WHO criteria. The prevalence of GDM was 14% in this study. Fisher's exact test and Chi-square test were used for initial comparisons. Univariate and multivariate logistic regression were performed to estimate crude odds ratios (cOR) and adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) for factors associated with GDM. In the adjusted analysis, obesity class II (aOR: 9.929, 95% CI: 1.174-83.983, p = 0.035) and obesity class III (aOR: 26.945, 95% CI: 1.101-659.624, p = 0.044) were significantly associated with increased odds of GDM. However, the wide confidence intervals suggest limited precision of these estimates. Parental history of diabetes (aOR: 3.079, 95% CI: 1.275-7.432, p = 0.012), betel quid chewing (aOR: 2.689, 95% CI: 1.010-7.160, p = 0.048), and sugar-sweetened beverage intake (aOR: 3.827, 95% CI: 1.649-8.880, p = 0.002) were also significantly associated with increased odds of GDM. In contrast, maternal age (aOR: 0.996, 95% CI: 0.911-1.088, p = 0.922), pre-obesity (aOR: 2.238, 95% CI: 0.461-10.864, p = 0.317), obesity class I (aOR: 4.515, 95% CI: 0.921-22.139, p = 0.063) and oral contraceptive use (aOR: 2.136, 95% CI: 0.871-5.240, p = 0.097) were not significantly associated with GDM after adjustment. The first pregnancy was associated with lower odds of GDM in the crude analysis; however, this association was no longer statistically significant after adjustment (aOR: 0.382, 95% CI: 0.118-1.241, p = 0.110). These findings highlight the multifactorial nature of GDM, with both genetic susceptibility and modifiable lifestyle behaviours contributing to its development. Targeted awareness initiatives focusing on dietary behaviours, particularly reducing the consumption of sugar-sweetened beverages, may be beneficial in similar populations, alongside early screening of women with a family history of diabetes.