A population-based screening for gestational diabetes mellitus in non-diabetic women in Bahrain.
BACKGROUND
Maternal hyperglycemia is considered a risk factor for fetal morbidity. Since there is a high prevalence of diabetes mellitus among the population of Bahrain, we conducted a prospective population-based study of gestational diabetes mellitus (GDM) in non-diabetic pregnant women.


METHODS
All non-diabetic pregnant women attending antenatal clinics during January 2001 to December 2002 (n=10,495) were screened for GDM during the 24th to 28th weeks of gestation. All positive subjects based on a 50-g glucose challenge test (GCT) were further evaluated by a diagnostic 75-g oral glucose tolerance test (OGTT). The birth weight of the child and post-delivery insulin resistance were monitored. The homeostasis model of insulin resistance (HOMA-IR) was used to assess insulin resistance.


RESULTS
Of 10,495 non-diabetic pregnant women screened, 32.8% (n=3443) had plasma glucose > or = 7.8 mmol/L (140 mg/dL) in the GCT. The 75-g OGTT found a prevalence of GDM of 13.5%. There were twice as many Bahrainis as expatriates. Of children born to women with GDM, 6.5% had a birth weight > 4000 g. Post-delivery evaluation of insulin resistance indicated that 33% of women with GDM had a HOMA-IR value > 2.


CONCLUSIONS
The population of Bahrain is a high-risk ethnic group for GDM. The association of insulin resistance in the post-gravid state with GDM among 33% of the study population suggests that insulin resistance, the possible cause of the pathophysiological mechanism underlying the development of gestational diabetes, continues in the post gravid state.
Department of Medicine, Salmaniya Medical Complex, Manama Kingdom of Bahrain.
Salwa
S
Al Mahroos
Das S
DS
Nagalla
Wafa
W
Yousif
Hasan
H
Sanad
D001445:Bahrain / Q000453:epidemiology; D001724:Birth Weight; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D011247:Pregnancy; D011446:Prospective Studies