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CC BY-NC-ND 4.0 · Exp Clin Endocrinol Diabetes 2022; 130(12): 821-827
DOI: 10.1055/a-1869-4159
Article

Screening for Gestational Diabetes Mellitus and Pregnancy Outcomes: Results from a Multicentric Study in Tajikistan

Dilnoza Pirmatova
1   Department of Obstetrics and Gynecology No 1, Avicenna Tajik State Medical University (ATSMU), Rudaki av., Dushanbe, Tajikistan
9   Center for International Health (CIH), LMU, Munich, Germany
,
Munavvara Dodkhoeva
1   Department of Obstetrics and Gynecology No 1, Avicenna Tajik State Medical University (ATSMU), Rudaki av., Dushanbe, Tajikistan
,
Uwe Hasbargen
2   Department of Obstetrics and Gynecology LMU Medical Center, Munich, Germany
,
Andreas W. Flemmer
3   Div. Neonatology, University Children’s Hospital and Perinatal Center, LMU Medical Center, Munich, Germany
,
Zulfiya Abdusamatzoda
4   Ministry of Health and Social Protection of the Population of the Republic of Tajikistan, Shevchenko, Dushanbe, Tajikistan
,
Khursheda Saburova
5   Department of Delivery, Khatlon Regional Clinical Hospital named after Buri Vokhidov, Bokhtar, Tajikistan
,
Nasiba Salieva
6   Department of Neonatology, State Institution Health Complex «Istiklol», N. Karaboev av. Dushanbe, Tajikistan
,
Surayyo Radzhabova
7   Department of Reproductive Health, City Health Center, Dushanbe, Tajikistan
,
Klaus G. Parhofer
8   Medical Department IV, LMU Medical Center, Munich, Germany
9   Center for International Health (CIH), LMU, Munich, Germany
› Author Affiliations Funding This study was supported by a grant from the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung) to Klaus G. Parhofer (Förderkennzeichen 01DK14022).
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Abstract

The prevalence of gestational diabetes parallels the prevalence of type 2 diabetes mellitus and is associated with adverse pregnancy outcomes. However, these data are not available for many parts of the world. We assessed the prevalence of gestational diabetes and pregnancy outcomes in Tajikistan. This cohort study included 2438 consecutively recruited representative pregnant women from 8 locations in two cities in Tajikistan, in whom an oral glucose tolerance test (75 g, fasting, 1 h, 2 h) was performed during gestational weeks 24–28. Women with known diabetes and twin pregnancies were excluded. Associations between glucose tolerance test results and pregnancy outcomes were examined. According to the WHO 2013 thresholds, 32.4% of women qualified as having gestational diabetes, the vast majority (29.7%) based on an elevated fasting glucose level (5.1–5.6 mmol/L), while only 2.8% had elevated 1- or 2-hour values or met more than one threshold. Women with only elevated fasting glucose (impaired gestational fasting glycemia) had no evidence of adverse pregnancy outcomes, while those with elevated 1- and/or 2-hour values (impaired gestational glucose tolerance) had more pregnancy complications (infection of urinary tract 1.8 vs. 8.8% p<0.001; preeclampsia 0.7 vs. 10.3% p<0.001) and emergency cesarean sections (4.4 vs. 13.2% p=0.002). Neonates from pregnancies with impaired gestational glucose tolerance had lower APGARs, lower birth weights, lower 30 min glucose levels, and a lower probability of being discharged alive (all p<0.05). In conclusion, the formal prevalence of gestational diabetes is high in Tajikistan; however, this does not translate into adverse pregnancy outcomes for women with impaired gestational fasting glycemia.

Key words

Central Asia - oral glucose tolerance test - maternal outcome - neonatal outcome - neonatal hypoglycemia


Publication History

Received: 26 April 2022
Received: 20 May 2022

Accepted: 31 May 2022

Article published online:
26 July 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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