title: Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India.
abstract: BACKGROUND
  Hyperglycaemia in pregnancy (HIP), i.e. gestational diabetes mellitus (GDM) and diabetes in pregnancy (DIP), increases the risk of various short- and long-term adverse outcomes. However, much remains to be understood about the role of different risk factors in development of HIP.
  
  
  OBJECTIVE
  The aims of this observational study were to examine the role of potential risk factors for HIP, and to investigate whether any single or accumulated risk factor(s) could be used to predict HIP among women attending GDM screening at three centres in urban, semi-urban and rural Tamil Nadu, India.
  
  
  METHODS
  Pregnant women underwent a 75 g oral glucose tolerance test. Data on potential risk factors was collected and analysed using logistical regression analysis. Receiver operating characteristic (ROC) curves, sensitivity, specificity and predictive values were calculated for significant risk factors and a risk factor scoring variable was constructed.
  
  
  RESULTS
  HIP was prevalent in 18.9% of the study population (16.3% GDM; 2.6% DIP). Increasing age and BMI as well as having a mother only or both parents with diabetes were significant independent risk factors for HIP. Among women attending the rural health centre a doubling of income corresponded to an 80% increased risk of HIP (OR 1.80, 95%CI 1.10-2.93; p = 0.019), whereas it was not significantly associated with HIP among women attending the other health centres. The performance of the individual risk factors and the constructed scoring variable differed substantially between the three health centres, but none of them were good enough to discriminate between those with and without HIP.
  
  
  CONCLUSIONS
  The findings highlight the importance of socio-economic circumstances and intergenerational risk transmission in the occurrence of HIP as well as the need for universal screening.
authors.affiliation: Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.|World Diabetes Foundation, Gentofte, Denmark.
authors.forename: Karoline
authors.initials: K
authors.lastname: Kragelund Nielsen
authors.affiliation: Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.|Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Damm
authors.affiliation: World Diabetes Foundation, Gentofte, Denmark.
authors.forename: Anil
authors.initials: A
authors.lastname: Kapur
authors.affiliation: Dr. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India.
authors.forename: Vijayam
authors.initials: V
authors.lastname: Balaji
authors.affiliation: Dr. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India.
authors.forename: Madhuri S
authors.initials: MS
authors.lastname: Balaji
authors.affiliation: Dr. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India.
authors.forename: Veerasamy
authors.initials: V
authors.lastname: Seshiah
authors.affiliation: Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ib C
authors.initials: IC
authors.lastname: Bygbjerg
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D007194:India / Q000453:epidemiology / Q000208:ethnology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D012307:Risk Factors