Prevalence and Complications of Pregestational and Gestational Diabetes in Saudi Women: Analysis from Riyadh Mother and Baby Cohort Study (RAHMA)

Abstract

The objectives of this study were to estimate the burden of diabetes and to explore the adverse pregnancy outcomes associated with pregestational diabetes mellitus (pre-GDM) and gestational diabetes mellitus (GDM) among the Saudi pregnant population. In this subcohort, we compared the maternal and the neonatal outcomes of diabetic women with pre-GDM and GDM to the outcomes of nondiabetic mothers who delivered during the same period. From the total cohort, 9723 women participated in this study. Of the participants, 24.2% had GDM, 4.3% had pre-GDM, and 6951 were nondiabetic. After adjustment for confounders, women with GDM had increased odds of delivering a macrosomic baby (OR: 1.6; 95% CI: 1.2–2.1). Women with pre-GDM were more likely to deliver by Cesarean section (OR: 1.65; CI: 1.32–2.07) and to have preterm delivery < 37 weeks (OR: 2.1; CI: 1.5–2.8). Neonates of mothers with pre-GDM were at increased risk of being stillbirth (OR: 3.66; CI: 1.98–6.72), at increased risk of admission to NICU (OR: 2.21; CI: 1.5–3.27), and at increased risk for being macrosomic (OR: 2.40; CI: 1.50–3.8). The prevalence of GDM and pre-GDM in the Saudi pregnant population is among the highest in the world. The conditions are associated with high maternal and neonatal morbidities and mortalities.

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

“…These cohorts consistently found that pregnant women with pre-GDM or GDM were at increased risk of various adverse maternal and birth outcomes including CS delivery, macrosomia, and preterm delivery [26,48,67,88]. Pre-GDM was also independently associated with CS delivery (adjusted odds ratio "aOR," 1.65), induction of labor (aOR, 1.67), macrosomia (aOR, 1.40), stillbirth (aOR, 3.66), and APGAR score < 7 at 5 min (aOR, 3.82) [67]. Various unfavorable health outcomes were more common in grand multipara compared to primigravida mothers [82,114] (see Additional file 3: Table S2).…”

“…Thirty-four cohort studies (42.0%) were identified as a prospective design (19 in [81], and three in the UAE). Fiftytwo (64.2%) cohort studies enrolled pregnant mothers at varying stages of their pregnancy with different characteristics such as diabetic and non-diabetic mothers [26,67], obesity [42,47,54], singleton [41,48,99] or triplet pregnancies [91], teenage women [112], multipara women [82,86,98], and women with systemic lupus erythematosus (SLE) [27]. Eight studies (9.9%) enrolled pregnant mothers at varying stages after delivery [24,49,58,59,81,84,88,99].…”

“…Maternal or reproductive exposures often measured were GDM and parity in 24.7% and 16.0% of the 81 cohort studies, respectively. GDM was investigated as an exposure for different maternal and birth outcomes including mode of birth delivery, birth weight, APGAR score, preterm delivery, intrauterine fetal death, and admission to neonatal intensive care unit (NICU) in four cohort studies [26,48,67,88]. These cohorts consistently found that pregnant women with pre-GDM or GDM were at increased risk of various adverse maternal and birth outcomes including CS delivery, macrosomia, and preterm delivery [26,48,67,88].…”

“…GDM was investigated as an exposure for different maternal and birth outcomes including mode of birth delivery, birth weight, APGAR score, preterm delivery, intrauterine fetal death, and admission to neonatal intensive care unit (NICU) in four cohort studies [26,48,67,88]. These cohorts consistently found that pregnant women with pre-GDM or GDM were at increased risk of various adverse maternal and birth outcomes including CS delivery, macrosomia, and preterm delivery [26,48,67,88]. Pre-GDM was also independently associated with CS delivery (adjusted odds ratio "aOR," 1.65), induction of labor (aOR, 1.67), macrosomia (aOR, 1.40), stillbirth (aOR, 3.66), and APGAR score < 7 at 5 min (aOR, 3.82) [67].…”

Plasma concentrations of vitamin A and E and risk of dysglycemia in first-trimester pregnant Saudi women

“…In Saudi Arabia, the rising trends of obesity have led to greater incidence of T2DM, with greater proportions of pregnant women with undiagnosed T2DM [3]. A cohort study from Riyadh, Saudi Arabia, estimated the prevalence of Pre-GDM and GDM to be around 4.3% and 24.2%, respectively, indicating a great burden of diabetes among pregnant women in Saudi Arabia [4]. Pregnancy is a period of specific nutritional needs to support health of the mother and the fetus [5].…”