JMIR Publications

ABSTRACT

Background:

The prevalence of GDM and its associated factors have not been investigated in Vietnam, especially in the rural Vietnam.

Objective:

To determine the prevalence and associated factors for gestational diabetes mellitus (GDM) in rural areas of Vietnam.

Methods:

This cross-sectional study was conducted among 1003 pregnant women, aged ≥18 years in rural areas of Northern Vietnam. GDM was identified as an impaired oral glucose tolerance test based on the guidelines of the International Association of the Diabetes and Pregnancy Study Groups. Associated factors for GDM were analyzed using modified Poisson regression with robust (sandwich) SE analysis with maternal age, pre-pregnancy body mass index (BMI) and family history of diabetes as explanatory factors, adjusted for parity, method of conception, hormonal therapy for pregnancy maintenance, physical inactivity, and history of chronic medical conditions.

Results:

The prevalence of GDM was 26.2%. Patients with GDM were more likely to be older than control group with OR = 3.33, 95%CI = [2.31 – 4.78]. In the multivariable analysis, maternal age was strongly associated with gestational diabetes mellitus (GDM). Compared with women aged <25 years, those aged 25–34 years had a significantly higher prevalence of GDM (adjusted PR = 1.50; 95%CI: 1.12–1.99; p = 0.006). The rate was even higher among women aged ≥35 years (adjusted PR = 2.40; 95%CI: 1.74–3.31; p<0.0001). These associations remained consistent after further adjustment for confounders (25–34 years: adjusted PR = 1.44; 95%CI: 1.07–1.95; p = 0.02; ≥35 years: adjusted PR = 2.15; 95%CI: 1.49–3.11; p<0.0001). Overweight women (BMI 23–<25 kg/m²) showed a borderline association with GDM (adjusted PR = 1.39; 95%CI: 0.98–1.98; p = 0.06), while women with BMI ≥25 kg/m² had a significantly higher prevalence (adjusted PR = 1.58; 95%CI: 1.10–2.26; p = 0.01). These findings persisted adjusted model, with BMI ≥25 kg/m² remaining significantly associated with GDM (adjusted PR = 1.54; 95%CI: 1.10–2.17; p = 0.01). Women with a family history of diabetes had increased prevalence of GDM in both models, though the association reached marginal significance (adjusted PR = 1.51; 95%CI: 0.85–2.68; p = 0.16). Most additional covariates included in multivariable analysis were not significant. However, women who conceived via in vitro fertilization had significantly higher prevalence of GDM compared with natural conception (adjusted PR = 1.38; 95%CI: 1.04–1.85; p = 0.03). Use of hormonal therapy to maintain pregnancy was also associated with increased risk (adjusted PR = 1.32; 95%CI: 1.04–1.68; p = 0.02).

Conclusions:

The findings highlight the need for early screening and counseling before pregnancy. Lifestyle programs should focus on weight control and healthy habits. Future research should test whether these programs can reduce the rate of gestational diabetes in rural communities.