Hui Wang1, Ninghua Li1, Tawanda Chivese2, Mahmoud Werfalli3, Hong Sun4, Lili Yuen5, Cecilia Ambrosius Hoegfeldt6, Camille Elise Powe7, Jincy Immanuel5, Suvi Karuranga4, Hema Divakar8, NAomi Levitt9, Changping Li1, David Simmons6, Xilin Yang10. 1. Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University and Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. 2. Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar. 3. Department of Family and Community Medicine, Faculty of Medicine, University of Benghazi, Benghazi, Libya. 4. International Diabetes Federation, Brussels, Belgium. 5. School of Medicine, Western Sydney University, Campbelltown, Australia. 6. Department of Psychiatry, University of Oxford, Oxford, UK. 7. Diabetes Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, USA. 8. Divakars Specialty Hospital, Bangalore, India. 9. Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa; Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa. 10. Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University and Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address: yangxilin@tmu.edu.cn.
Abstract
AIMS: The approaches used to screen and diagnose gestational diabetes mellitus (GDM) vary widely. We generated a comparable estimate of the global and regional prevalence of GDM by International Association of Diabetes in Pregnancy Study Group (IADPSG)'s criteria. METHODS: We searched PubMed and other databases and retrieved 57 studies to estimate the prevalence of GDM. Prevalence rate ratios of different diagnostic criteria, screening strategies and age groups, were used to standardize the prevalence of GDM in individual studies included in the analysis. Fixed effects meta-analysis was conducted to estimate standardized pooled prevalence of GDM by IDF regions and World Bank country income groups. RESULTS: The pooled global standardized prevalence of GDM was 14.0% (95% confidence interval: 13.97-14.04%). The regional standardized prevalence of GDM were 7.1% (7.0-7.2%) in North America and Caribbean (NAC), 7.8% (7.2-8.4%) in Europe (EUR), 10.4% (10.1-10.7%) in South America and Central America (SACA), 14.2% (14.0-14.4%) in Africa (AFR), 14.7% (14.7-14.8%) in Western Pacific (WP), 20.8% (20.2-21.4%) in South-East Asia (SEA) and 27.6% (26.9-28.4%) in Middle East and North Africa (MENA). The standardized prevalence of GDM in low-, middle- and high-income countries were 12.7% (11.0-14.6%), 9.2% (9.0-9.3%) and 14.2% (14.1-14.2%), respectively. CONCLUSIONS: The highest standardized prevalence of GDM was in MENA and SEA, followed by WP and AFR. Among the three World Bank country income groups, high income countries had the highest standardized prevalence of GDM. The standardized estimates for the prevalence of GDM provide an insight for the global picture of GDM.
AIMS: The approaches used to screen and diagnose gestational diabetes mellitus (GDM) vary widely. We generated a comparable estimate of the global and regional prevalence of GDM by International Association of Diabetes in Pregnancy Study Group (IADPSG)'s criteria. METHODS: We searched PubMed and other databases and retrieved 57 studies to estimate the prevalence of GDM. Prevalence rate ratios of different diagnostic criteria, screening strategies and age groups, were used to standardize the prevalence of GDM in individual studies included in the analysis. Fixed effects meta-analysis was conducted to estimate standardized pooled prevalence of GDM by IDF regions and World Bank country income groups. RESULTS: The pooled global standardized prevalence of GDM was 14.0% (95% confidence interval: 13.97-14.04%). The regional standardized prevalence of GDM were 7.1% (7.0-7.2%) in North America and Caribbean (NAC), 7.8% (7.2-8.4%) in Europe (EUR), 10.4% (10.1-10.7%) in South America and Central America (SACA), 14.2% (14.0-14.4%) in Africa (AFR), 14.7% (14.7-14.8%) in Western Pacific (WP), 20.8% (20.2-21.4%) in South-East Asia (SEA) and 27.6% (26.9-28.4%) in Middle East and North Africa (MENA). The standardized prevalence of GDM in low-, middle- and high-income countries were 12.7% (11.0-14.6%), 9.2% (9.0-9.3%) and 14.2% (14.1-14.2%), respectively. CONCLUSIONS: The highest standardized prevalence of GDM was in MENA and SEA, followed by WP and AFR. Among the three World Bank country income groups, high income countries had the highest standardized prevalence of GDM. The standardized estimates for the prevalence of GDM provide an insight for the global picture of GDM.