International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2013
Incidence of adverse outcomes associated with gestational diabetes mellitus in low- and middle-income countries.
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Wang Zheng, Kanguru Lovney, Hussein Julia, Fitzmaurice Ann, Ritchie Katherine
Аннотация
BACKGROUND: The contribution of medical conditions such as diabetes mellitus to maternal and neonatal ill-health in low- and middle-income countries is not well documented.
OBJECTIVES: To ascertain the incidence of adverse outcomes associated with gestational diabetes mellitus (GDM) in these countries.
SEARCH STRATEGY: Electronic databases were searched between 1990 and 2011.
SELECTION CRITERIA: Observational, experimental, and quasi-experimental studies reporting adverse outcomes associated with GDM in mothers and their infants in low- and middle-income countries were included.
DATA COLLECTION AND ANALYSIS: Titles and abstracts were screened, and full-text articles were independently assessed by at least 2 reviewers. Characteristics of studies were tabulated and quality assessment performed. Median and interquartile range (IQR) were computed for each adverse outcome.
MAIN RESULTS: 25 articles were included from an initial 1282 citations. High median incidences of cesarean (43.8%; IQR, 34.9%-65.9%), neonatal jaundice (17.1%; IQR, 8.5%-22.9%), and macrosomia (17.0%; IQR, 8.3%-32.5%) were reported in women with GDM.
CONCLUSIONS: The high incidence of some complications of GDM is a concern and may indicate poorer care for women with GDM in low-resource settings. The wide IQRs found indicate uncertainty about the burden of GDM in these settings.
OBJECTIVES: To ascertain the incidence of adverse outcomes associated with gestational diabetes mellitus (GDM) in these countries.
SEARCH STRATEGY: Electronic databases were searched between 1990 and 2011.
SELECTION CRITERIA: Observational, experimental, and quasi-experimental studies reporting adverse outcomes associated with GDM in mothers and their infants in low- and middle-income countries were included.
DATA COLLECTION AND ANALYSIS: Titles and abstracts were screened, and full-text articles were independently assessed by at least 2 reviewers. Characteristics of studies were tabulated and quality assessment performed. Median and interquartile range (IQR) were computed for each adverse outcome.
MAIN RESULTS: 25 articles were included from an initial 1282 citations. High median incidences of cesarean (43.8%; IQR, 34.9%-65.9%), neonatal jaundice (17.1%; IQR, 8.5%-22.9%), and macrosomia (17.0%; IQR, 8.3%-32.5%) were reported in women with GDM.
CONCLUSIONS: The high incidence of some complications of GDM is a concern and may indicate poorer care for women with GDM in low-resource settings. The wide IQRs found indicate uncertainty about the burden of GDM in these settings.