Incidence of adverse outcomes associated with gestational diabetes mellitus in low- and middle-income countries

Background: The contribution of medical conditions such as diabetes mellitus to maternal and neonatal ill-health in low- and middle-income countries is not well documented. Objectives: To ascertain the incidence of adverse outcomes associated with gestational diabetes mellitus (GDM) in these countries.

Search strategy:Electronic databases were searched between 1990 and 2011. Selection criteria: Observational, experimental, and quasi-experimental studies reporting adverse outcomes associated with GDM in mothers and their infants
in low- and middle-income countries were included.

Data collection and analysis: Titles and abstracts were screened, and full-text articles were independently assessed by at least 2 reviewers. Characteristics of
studies were tabulated and quality assessment performed. Median and interquartile range (IQR) were computed for each adverse outcome.

Main results: 25 articles were included from an initial 1282 citations. High
median incidences of cesarean (43.8%; IQR, 34.9%–65.9%), neonatal jaundice (17.1%; IQR, 8.5%–22.9%), and macrosomia (17.0%; IQR, 8.3%–32.5%) were reported in women with GDM.

Conclusions: The high incidence of some complications of GDM is a concern and may indicate poorer care for women with GDM in low-resource settings. The wide IQRs found indicate uncertainty about the burden of GDM in these settings.