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Prevalence of gestational diabetes and identification of associated factors and maternal-perinatal outcomes in Colombia following the implementation of the IADPSG criteria
Prevalencia de diabetes gestacional e identificación de factores y resultados materno-perinatales asociados en Colombia, tras la implementación de los criterios de la IADPSG
DOI:
https://doi.org/10.15446/revfacmed.v69n2.80195Palabras clave:
Gestational Diabetes, Prevalence, Risks, Maternal Health (en)Diabetes gestacional, Prevalencia, Riesgo, Salud materna (es)
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Introduction: Timely diagnosis and treatment of gestational diabetes (GD), as well as adequate control of associated risk factors, allows reducing its negative impact on maternal and perinatal health.
Objectives: To determine the prevalence of GD in a tertiary care hospital in Colombia and identify the risk factors associated with this condition, as well as the maternal-perinatal outcomes in this population, following the implementation of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria.
Materials and methods: Cross-sectional study in which a secondary data analysis was carried out. By means of consecutive sampling, 533 pregnant women with GD who gave birth at the Hospital Universitario San José in Popayán, Colombia, between July 2017 and March 2018, were included. Social, biological, and psychological variables were analyzed. To identify risk factors and associated maternal-perinatal outcomes, the Odds Ratio was used as a measure of association (CI:95%). In addition, a multivariate analysis was performed to control for confounding factors.
Results: The prevalence of GD was 16.32% (95%CI:13.28-19.73). The following risk factors associated with GD were identified: age >35 (OR=2.26; 95%CI:1.23-4.14), indigenous race (OR=6.60; 95%CI:1.17-37.15), BMI >25 (OR=2. 26; 95%CI:1.23-4.14), history of fetal macrosomia (OR=10.07; 95%CI: 1.50-67.34), and family history of diabetes mellitus (OR=3.17; 95%CI:1.39-7.22). Regarding maternal-perinatal outcomes, a significant association was found with labor induction (OR=4.41; 95%CI:1.71-11.39), emergency cesarean section (OR=2.22; 95%CI:1.33-3.73), elective cesarean section (OR=2.79; 95%CI:1.51-5.18), fetal weight >90th percentile (OR=2.78; 95%CI:1.29-5.98), and neonatal hospitalization (OR=8.1; 95%CI:4.48-18.62).
Conclusions: The prevalence of GD reported here is higher than the prevalence described in other studies conducted in Colombia, but similar to most studies that have followed the IADPSG criteria. Likewise, risk factors and maternal-perinatal outcomes that had a statistically significant association with GD here are similar to those described in most of the studies that were consulted.
Introducción. El diagnóstico y manejo oportuno de la diabetes gestacional (DG) y el adecuado control de factores de riesgo asociados permiten disminuir su impacto negativo en la salud materna y perinatal. Objetivos. Determinar la prevalencia de DG en un hospital de tercer nivel de Colombia e identificar los factores asociados a esta condición, así como los resultados materno-perinatales en esta población, tras la implementación de los criterios de la Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo (IADPSG).
Materiales y métodos. Estudio transversal en el que se realizó un análisis de datos secundarios. Mediante muestreo consecutivo se incluyeron 533 gestantes con reporte de prueba diagnóstica de DG y que dieron a luz en el Hospital Universitario San José de Popayán, Colombia, entre julio de 2017 y marzo de 2018. Se analizaron variables sociales, biológicas y psicológicas. Para la identificación de los factores y resultados materno- perinatales asociados se utilizó el Odds Ratio como medida de asociación (IC: 95%). Además, se realizó un análisis multivariado para controlar las variables de confusión.
Resultados. La prevalencia de DG fue del 16.32% (IC95%:13.28-19.73). Se identificaron los siguientes factores asociados a DG: edad >35 (OR=2.26; IC95%: 1.23-4.14), raza indígena (OR=6.60; IC95%: 1.17-37.15), IMC preconcepcional >25 (OR=2.26; IC95%: 1.23-4.14), antecedente de feto macrosómico (OR=10.07; IC95%: 1.50-67.34) y antecedente familiar de diabetes mellitus (OR=3.17; IC95%: 1.39-7.22). Respecto a los resultados materno-perinatales, se encontró una asociación significativa con inducción del trabajo de parto (OR=4.41; IC95%: 1.71-11.39), cesárea de urgencia (OR=2.22; IC95%: 1.33-3.73) y electiva (OR=2.79; IC95%: 1.51-5.18), macrosomia por percentil >90 (OR=2.78; IC95%: 1.29-5.98) y hospitalización neonatal (OR=8.1; IC95%: 4.48-18.62).
Conclusiones. La prevalencia de DG en el presente estudio es mayor a la reportada en investigaciones realizadas en Colombia, pero similar a la descrita en la mayoría de estudios que han seguido los criterios de la IADPSG. Los factores y los resultados maternos-perinatales en los que se observó una asociación estadísticamente significativa con la DG son similares a los reportados en la mayoría de la literatura consultada.
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