Frequency of Intrauterine Growth Restriction Associated with Hypertensive Disorders of Pregnancy

Abstract

Background: Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and fetal outcomes, particularly among obese women. Understanding the prevalence and risk factors for GDM in this population is crucial for effective clinical management and prevention strategies. Objective: This study aimed to determine the frequency of GDM among obese pregnant women and assess its association with body mass index (BMI) categories, as well as to investigate obstetric outcomes associated with GDM in this cohort. Methods: This was a cross-sectional study conducted at Khyber Teaching Hospital, Peshawar, from February 2021 to July 2022. The sample size was calculated to be 152 participants. Inclusion criteria included pregnant women with a BMI of 30 or greater. Exclusion criteria were women with pre-existing diabetes mellitus and multiple pregnancies. Data collection involved direct interviews and medical record reviews, capturing demographic information, medical history, BMI measurements, and glucose tolerance test results. GDM was diagnosed according to the American Diabetes Association criteria. Statistical analysis was performed using SPSS version 25.0, with a significance level set at p ≤ 0.05. Results: Among the 152 participants, the mean age was 28.6±4.8 years. The prevalence of GDM was found to be 29.6%. Of the participants, 46% had a period of gestation (POG) of less than 37 weeks, and 54% had a POG of 37 weeks or more. BMI distribution showed that 47% of women had a BMI of 30-34.9 kg/m², and 53% had a BMI of 35 kg/m² or greater. Gravida distribution indicated that 35% were primigravida, and 65% were multigravida. The prevalence of GDM was significantly higher in women with a BMI of 35 or greater (38.5%) compared to those with a BMI of 30-34.9 (22.9%) (p = 0.031). Women with GDM had higher incidences of preeclampsia (31.1% vs. 12.1%, p = 0.008) and cesarean delivery (53.3% vs. 29.0%, p = 0.015). Conclusion: The study highlights a high frequency of GDM among obese pregnant women, emphasizing the importance of addressing obesity as a modifiable risk factor for GDM. Effective strategies for GDM screening and management in obese populations are essential to improve maternal and fetal outcomes.