From the Guidelines
Approximately 5.8% to 12.9% of pregnant women develop gestational diabetes during pregnancy, with the prevalence varying significantly based on population demographics and diagnostic criteria used. The prevalence of gestational diabetes mellitus (GDM) is a significant concern, with a substantial increase in its prevalence in different ethnic groups and countries over the last several years 1. According to recent studies, the estimated median prevalence of GDM is around 5.8% in Europe and 12.9% in the Middle East and North Africa 1. In the United States, the prevalence of GDM is estimated to be around 6% to 7%, affecting approximately 240,000 of 4 million annual births 1.
Risk Factors and Screening
Women with risk factors such as obesity, advanced maternal age (over 35), family history of diabetes, previous gestational diabetes, or belonging to certain ethnic groups (Hispanic, African American, Native American, South or East Asian, Pacific Islander) have higher rates of GDM 1. Regular screening during pregnancy, typically between 24-28 weeks with a glucose tolerance test, is essential for early detection and management of GDM 1.
Management and Outcomes
GDM is associated with serious maternal and fetal complications, and mothers who have been affected by GDM are also at risk of developing type 2 diabetes and cardiometabolic disorders later in life 1. The risk of adverse effects of GDM can be minimized by good control over maternal blood glucose, diet, and physical activities 1. Recent studies have shown that technology-based self-management systems can offer advantages such as reducing patient travel and waiting time, saving medical practitioner time, and reducing costs to both the health care system and patients 1.
Key Considerations
The prevalence of GDM can be managed and reduced with proper screening, diagnosis, and treatment, and it is essential to consider the use of technology to support GDM self-management and improve pregnancy outcomes 1. Healthcare providers should prioritize early detection and management of GDM to minimize the risk of adverse effects and improve the quality of life for women with GDM and their infants.
From the Research
Gestational Diabetes Prevalence
- The prevalence of gestational diabetes mellitus (GDM) is estimated to affect up to 4% of pregnancies 2.
- However, the exact percentage of women who develop GDM is not consistently reported across studies.
- A review of maternal and fetal growth factors in diabetic pregnancy notes that diabetes mellitus complicates 1-2% of all pregnancies, but this includes both pre-gestational and gestational diabetes 2.
Risk Factors and Associations
- GDM is associated with an increased risk of fetal macrosomia, preeclampsia, and other adverse maternal and neonatal outcomes 3, 4, 5, 6.
- Excess gestational weight gain is a significant risk factor for adverse outcomes in women with GDM, including cesarean delivery, preeclampsia, and macrosomia 5.
- A correlation between GDM and preeclampsia has been observed, with GDM increasing the risk of preeclampsia and vice versa 6.
Maternal and Neonatal Outcomes
- Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age and developing type II diabetes later in life 3.
- GDM is also associated with an increased risk of neonatal intensive care unit admission, neonatal hypoglycemia, and large for gestational age 4.
- Maternal outcomes, such as cesarean delivery and postpartum hemorrhage, are also more common in women with GDM 3, 4, 5.