Screening and Diagnosis of Gestational Diabetes Mellitus in Asia: A Systematic Literature Review
Nurbita Fajarini (a*), Mufdlilah (b), Yekti Satriyandari (b), Sri Ratnaningsih (b)
(a) Master of midwifery student Universitas ‘Aisyiyah Yogyakarta
*nurbita.fajarini[at]gmail.com
(b) Midwifery Program, Faculty of Health Sciences, Universitas ‘Aisyiyah Yogyakarta
Ringroad Barat No.63, Mlangi, Nogotirto, Gamping, Kabupaten Sleman, Daerah Istimewa Yogyakarta,
Abstract
Background: Asian women are at high risk gestational diabetes mellitus (GDM). GDM is a pregnancy problem that characterized by glucose intolerance. Short and long term impacts can occur on both mother and child. Women with a GDM history have a risk of type 2 diabetes within 2-10 years. Appropriate screening and diagnosis are needed for preventing and early treatment of GDM. This study aims to review the literature on screening and diagnosis of gestational diabetes mellitus in Asia. Method: Systematic Literature Review from three databases, PubMed, ProQuest and Science Direct. Articles in English and published for the period 2009-2019, totaling 867 articles. Results: A total of 10 articles selected by inclusion criteria. Prevalence of GDM in Asia depending on the diagnostic criteria used, ranges from 2.75% to 41.5%. IADPSG and WHO are criteria often used. Screening and diagnosis, mostly done at 24-28 weeks gestation, with a one-step approach (75-g two-hour OGTT) as the method most often used. GDM risk factors included older age (> 35 years), BMI before pregnancy, DM family history, GDM history, obesity, recurrent abortion history, hypertension history, stillbirth history, infant macrosomia history, PCOS history, blood type AB. Pregnancy outcomes in the form of caesarean section were higher in the IADPSG and WHO criteria. The main obstacles in screening and diagnosis are related to health care provide resources, lack of patient interest and access to health services. Conclusion: Diagnostic criteria affect the prevalence of GDM in Asia. Health care provider resources, conditions and patient-s need including access to health services should be taken into consideration for determining GDM screening and diagnosis strategies.
Keywords: Gestational diabetes, screening, diagnosis, pregnancy, Asia
Topic: MATERNAL, NEONATAL, AND CHILD HEALTH