Sains Malaysiana 50(8)(2021): 2367-2377

http://doi.org/10.17576/jsm-2021-5008-19

Gestational Diabetes in Malaysia: A Systematic Review of Prevalence, Risk Factors and Outcomes

(Diabetes Gestasi di Malaysia: Suatu Kajian Sistematik Mengenai Prevalens, Faktor Risiko dan Akibat)

CHEONG LIENG TENG¹*, FOO KEN YONG², KA MUN LUM², SHEN YUNG TOH³, CHAN XUAN HII² & SIVALINGAM NALLIAH⁴

¹Department of Family Medicine, International Medical University, Seremban Campus, Jalan Rasah, 70300 Seremban, Negeri Sembilan Darul Khusus, Malaysia

²Ministry of Health Malaysia, Ibu Pejabat KKM Blok E1, E6, E7 & E10, Parcel E, Pusat Pentadbiran Kerajaan Persekutuan, 62590 Putrajaya, Federal Territory, Malaysia

³The University of New South Wales, Sydney NSW 2052, Australia

⁴Department of Obstetrics & Gynaecology, International Medical University, Seremban Campus, Jalan Rasah, 70300 Seremban, Negeri Sembilan Darul Khusus, Malaysia

Received: 14 June 2020/Accepted: 31 December 2020

ABSTRACT

Gestational diabetes mellitus (GDM) is glucose intolerance first diagnosed during pregnancy. In Malaysia, the prevalence, risk factors, and maternal/foetal outcomes vary somewhat among the local studies. In this systematic review of Malaysian studies, we synthesise relevant data from 13 journal articles (including 10,285 women with gestational diabetes). A meta-analysis of twelve datasets showed a prevalence of 21.5% (95% CI 17.3 to 25.9%, random effect model). Clinical factors in the mother found to increase her risk of GDM were consistent with international data. A meta-analysis of complications showed statistically significant increase for macrosomia (OR 3.08, 95% CI 1.77 to 5.36) but not for pre-eclampsia (OR 1.44, 95% CI 0.52 to 4.00) and caesarean delivery (OR 1.31, 95% CI 0.98 to 1.75). The high prevalence of gestational diabetes mellitus and documented adverse consequences support the need for universal screening of this condition in all pregnant women in Malaysia.

Keywords: Gestational diabetes; Malaysia; pregnancy; prevalence; risk factors

ABSTRAK

Diabetes gestasi (GDM) adalah keadaan intolerans glukosa yang pertama kali dikesan semasa kehamilan. Di Malaysia, prevalens, faktor risiko dan akibat penyakit ini agak berbeza di kalangan penyelidikan tempatan. Dalam kajian sistematik ke atas penyelidikan dari Malaysia, kami menggabungkan data daripada 13 artikel jurnal (termasuk 10,285 wanita yang mengidap diabetes gestasi). Analisa meta 12 set data menunjukkan prevalens ialah 21.5% (95% CI 17.3 - 25.9%, model kesan rawak). Faktor klinikal pada ibu yang meningkatkan risiko kepada GDM adalah selaras dengan data antarabangsa. Analisa meta ke atas komplikasi akibat GDM menunjukkan peningkatan signifikan secara statistik bagi makrosomia (OR 3.08, 95% CI 1.77 - 5.36) tetapi tidak untuk praeklampsia (OR 1.44, 95% CI 0.52 - 4.00) dan pembedahan caesarean (OR 1.31, 95% CI 0.98 - 1.75). Prevalens diabetes gestasi yang tinggi dan akibat buruk yang ditunjukkan menyokong perlunya saringan universal bagi penyakit ini di kalangan ibu mengandung di Malaysia.

Kata kunci: Diabetes gestasi; faktor risiko; kehamilan; Malaysia; prevalens

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*Corresponding author; email: tengcl@gmail.com