Diabetes and hypertension in pregnancy in a rural community of Bangladesh: a population-based study.
OBJECTIVE
Gestational diabetes mellitus (GDM) is associated with increased infant mortality. Diabetes and infant mortality is higher in Bangladesh but the prevalence of diabetes and hypertension in pregnancy is not known. Thus, this study addressed the prevalence of diabetes and hypertension in pregnancy.


METHODS
We selected 10 villages randomly in a union council of Nandail subdistrict. Following a population census (n = 14 382: male/female = 7476/6906) on demography and marital status, we interviewed 2205 married women (18-44 years) for detection of pregnancy. Of a total of 172 pregnancies, we investigated 147 with a gestational age of 24-28 weeks for obstetrical history, clinical examination and blood pressure (BP). Fasting (FBG) and 2-h blood glucose (2hBG) were assessed by Hemocue cuvette. WHO diagnostic criteria were used.


RESULTS
The overall prevalence (95% CI) of diabetes was 6.8% (1.88-9.32) and 8.2% (3.74-12.64) according to FBG and 2hBG, respectively. The crude prevalence of systolic and diastolic hypertension was 6.8 and 5.4%, respectively. The median (interquartile range) values for age, BMI and FBG of the participants were 25.0 (21.0-30.0) years, 19.5 (18.2-21.2) and 3.9 (3.6-4.3), respectively. The history of abortion, neonatal death and stillbirth was found in 19.9, 11.4 and 9.6%, respectively. The prevalence of GDM was higher among those with the history of stillbirth (15.4 vs. 6.0%) and neonatal death (11.8 vs. 6.2%) than those without.


CONCLUSIONS
The prevalence of GDM in rural Bangladesh is comparable with any other population with higher prevalence of GDM. Increased morbidity and mortality among mothers and newborns in Bangladesh may, in part, be because of increased prevalence of GDM.
Sayeed
M A
MA
Department of Community Medicine, Ibrahim Medical College, Segunbagicha, Dhaka, Bangladesh. sayeedma@dab-bd.org
Mahtab
H
H
Khanam
P A
PA
Begum
R
R
Banu
A
A
Azad Khan
A K
AK
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001459:Bangladesh / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D011159:Population Surveillance / Q000379:methods; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D015995:Prevalence; D012423:Rural Health
D001786:Blood Glucose