Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units

OBJECTIVE: To determine the prevalence and predictors of gestational diabetes mellitus (GDM) in rural Assam, India using a network of Mobile Medical Units. STUDY DESIGN: A field-based cross-sectional study. SETTINGS: Rural areas of Assam state, India. PARTICIPANTS: A total of 1410 pregnant women in gestational age of 24–28 weeks INTERVENTION: Identification of pregnant women in 24–28 weeks of pregnancy from villages and administering them Government of India recommended oral glucose tolerance test for GDM confirmation. PRIMARY AND SECONDARY OUTCOME MEASURES: Presence of gestational diabetes among pregnant women, risk factors and predictors of GDM. RESULTS: A total of 1212 pregnant women underwent the oral glucose tolerance test. One hundred and ninety-eight women were ineligible due to existing chronic diseases or very high blood glucose level before the test. The overall GDM prevalence in Assam was 16.67% (95% CI 14.61% to 18.89%). Women aged 26–30 years (adjusted odds ratio, aOR 1.70; CI 1.14 to 2.52), who passed 10th class (aOR 1.58; CI 1.05 to 2.37), belonging to Muslim religion (aOR 1.52; 95% CI 1.05 to 2.21) and above poverty line (aOR 1.38; 95% CI 1.00 to 1.91) had significantly increased likelihood of developing GDM compared with respective baseline groups (p<0.05). Body mass index, gravida and being non-anaemic were non-significant risk factors for GDM. Family history of diabetes (aOR 1.82; 95% CI 1.08 to 3.06) and smoking (aOR 1.61; 95% CI 1.10 to 2.35) were significant and independent predictors of GDM. CONCLUSION: The prevalence of GDM in rural Assam is high. The mobile medical units may play a significant role in the implementation of GDM screening, diagnosis, treatment to ensure better maternal and foetal health outcomes in rural Assam.