Frequency of Gestational Diabetes among Women presenting with Premature Rupture of Membranes
Keywords:
Diabetes Mellitus, Frequency, Gestational age, Premature Birth, Premature Rupture of Memberane, WomenAbstract
Objective: To evaluate the frequency of gestational diabetes among women who experience premature rupture of membranes
Methodology: This descriptive cross-sectional study was conducted at the Department of Obstetrics & Gynecology, Mohammad Teaching Hospital Peshawar, from October 2021 to February 2022. One hundred fifty-five patients were selected from the Obstetrics and Gynaecology outpatient department. Women presenting with premature membrane rupture, within the reproductive age of 15-45 years, and with a gestational period beyond 37 weeks were included. Women with a history of failed inductions and those with twin pregnancies confirmed by ultrasound were excluded. A consecutive sampling of 155 females with premature rupture of membranes and screening them for gestational diabetes mellitus. The SPSS (version 22.0) was used for statistical analysis. Categorical variables, including gestational diabetes, parity, and gravidity, were summarized using frequencies and percentages. We conducted post-stratification analysis using the chi-square test, with a significance level set at p < 0.05.
Results: The average age of the patients was 27.2±5.7 years, with the majority (49.7%) falling within the age range of up to 25 years. The mean parity was 2.49±1.84. Overall, we diagnosed gestational diabetes mellitus in 24.5% of the patients.
Conclusion: The presence of gestational diabetes mellitus in cases of premature rupture of membranes is familiar in our population. We recommend conducting further studies to identify risk factors and develop preventive strategies before formulating recommendations for its prevention.
References
Melamed N, Ben-Haroush A, Pardo J, Chen R, Hadar E, Hod M et al. Expectant management of preterm premature rupture of membranes: is it all about gestational age? Am J Obstet Gynecol. 2011; 204 (1): 48.e1-8. doi: 10.1016/j.ajog.2010.08.021. Epub 2010 Nov 11.
Laskin MD, Yinon Y, Whittle WL. Preterm premature rupture of membranes in the presence of cerclage: is the risk for intra-uterine infection and adverse neonatal outcome increased? J Matern Fetal Neonatal Med. 2012; 25(4): 424-8. doi: 10.3109/14767058.2011.569800.
Test G, Levy A, Wiznitzer A, Mazor M, Holcberg G, Zlotnik A et al. Factors affecting the latency period in patients with preterm premature rupture of membranes. Arch Gynecol Obstet. 2011; 283(4): 707-10. doi: 10.1007/s00404 -010-1448-7. Epub 2010 Mar 20.
Nayot D, Penava D, Da Silva O, Richardson BS, De Vrijer B. Neonatal outcomes are associated with latency after preterm premature rupture of membranes. J Perinatol. 2012; 32(12): 970-7. doi: 10.1038/jp.2012.15. Epub 2012 Mar 15.
van der Ham DP, van der Heyden JL, Opmeer BC, Mulder AL, Moonen RM, van Beek JHJ et al. Management of late-preterm premature rupture of membranes: the PPROMEXIL-2 trial. Am J Obstet Gynecol. 2012; 207(4): 276-e1. doi: 10.1016/j.ajog.2012.07.024. Epub 2012 Jul 20.
ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol. 2007; 109: 1007–1019. doi: 10.1097/01.AOG.000026388 8.69178.1f.
Zipori Y, Zidan R, Lauterbach R, hagag A, Ginsbery Y, Solt I, et al. Antenatal betamethasone and the risk of neonatal hypoglycemia: it's all about timing. Arch Gynecol Obstet. 2021; 303(3): 695-701. doi: 10.1007/s00404 -020-05785-y. Epub 2020 Sep 22.
Prelabor Rupture of Membranes: ACOG Practice Bulletin, Number 217. Obstet Gynecol. 2020; 135(3): e80-e97. doi: 10.1097/AOG.0000000000003700.
Melamed N, Berghella V, Ananth CV, Lipworth H, Yoon EW, Barrett J. Optimal Timing of Labor Induction after Prelabor Rupture of Membranes at Term: A Secondary Analysis of the TERMPROM Study. Am J Obstet Gynecol. 2023; 228(3): 326.e1-326.e13. doi: 10.1016/j.ajog.2022.09.018. Epub 2022 Sep 15.
Picón-César M.J. Molina-Vega M. Suárez-Arana M. Metformin for gestational diabetes study: metformin vs Insulin in gestational diabetes: glycemic control and obstetrical and perinatal outcomes: randomized prospective trial. Am J Obstet Gynecol. 2021; 225(5): 517. e1-517.e17. doi: 10.1016/j.ajog.2021.04.229. Epub 2021 Apr 19.
Anwer TZ, Aguayo R, Modest AM, Collier Ai-Ris Y. Reexamining intrapartum glucose control in patients with diabetes and risk of neonatal hypoglycemia. J Perinatol. 2021; 41(12): 2754-2760. doi: 10.1038/s41372-021-01292-3. Epub 2022 Jan 4.
Lende M, Rijhsinghani A. Gestational Diabetes: Overview with Emphasis on Medical Management. Int J Environ Res Public Health. 2020; 17(24): 9573. doi: 10.3390/ijerph17249573.
American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes. Diabetes Care. 2020; 43: S14-S31. doi: 10.2337/dc20-S002.
Ye W, Luo C, Huang J, Li C, Liu Z, Liu F. Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis. BMJ. 2022; 377: e067946. doi: 10.1136/bmj-2021-067946.
Darbandi M, Rezaeian S, Dianatinasab M, Yaghoobi H, Soltani M, Etemad K et al. Prevalence of Gestational Diabetes and Its Association with Stillbirth, Preterm Birth, Macrosomia, Abortion and Cesarean Delivery among Pregnant Women: A National Prevalence Study of 11 Provinces in Iran. J Prev Med Hyg. 2022; 62: E885–E891. doi: 10.15167/2421-4248/JPMH2021.62.4.178.
Zargar AH, Sheikh MI, Bashir MI, Masoodi SR, Laway BA, Wani AI et al. Prevalence of gestational Diabetes Mellitus in Kashmiri women from the Indian subcontinent. Diabetes Res Clin Pract. 2004; 66(2): 139-145. doi: 10.1016 /j.diabres.2004.02.023.
Kouhkan A, Najafi L, Malek M, Reza Baradaran H, Hosseini R, Khajavi A et al. Gestational Diabetes Mellitus: Major Risk Factors and Pregnancy-Related Outcomes: A Cohort Study. Int J Resprod Biomed. 2021; 19(9): 827–836. doi: 10.18502/ijrm. v19i9.9715.
Waters TP, Mercer BM. The management of preterm premature rupture of the membranes near the limit of fetal viability. Am J Obstet Gynecol. 2009; 201(3): 230-240. doi: 10.1016/j.ajog.2009.06.049.
Scott KA, Chambers BD, Baer RJ, Ryckman KK, McLemore MR, Jelliffe-Pawlowski LL. Preterm Birth and Nativity among Black Women with Gestational Diabetes in California, 2013–2017: A Population-Based Retrospective Cohort Study. BMC Pregnancy Childbirth. 2020; 20(1): 593. doi: 10.1186/s12884-020-03290-3.
Mistry SK, Das Gupta R, Alam S, Kaur K, Shamim AA, Puthussery S. Gestational Diabetes Mellitus (GDM) and Adverse Pregnancy Outcome in South Asia: A Systematic Review. Endocrinol Diabetes Metab. 2021; 4(4): e00285. doi: 10.1002/ edm2.285.
Reitzle L, Heidemann C, Baumert J, Kaltheuner M, Adamczewski H, Icks A et al. Pregnancy Complications in Women with Pregestational and Gestational Diabetes Mellitus. Dtsch Arztebl Int. 2023; 120(6): 81–86. doi: 10.3238/arztebl. m2022.0387.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Journal of Liaquat University of Medical & Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Submission of a manuscript to the journal implies that all authors have read and agreed to the content of the undertaking form or the Terms and Conditions.
When an article is accepted for publication, the author(s) retain the copyright and are required to grant the publisher the right of first publication and other non-exclusive publishing rights to JLUMHS.
Articles published in the Journal of Liaquat University of Medical & health sciences are open access articles under a Creative Commons Attribution-Noncommercial - Share Alike 4.0 License. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. This is in accordance with the BOAI definition of open access. In addition to that users are allowed to remix, tweak and build upon the work non-commercially as long as appropriate credit is given and the new creations are licensed under the identical terms. Or, in certain cases it can be stated that all articles and content there in are published under creative commons license unless stated otherwise.