Date of Conferral
2014
Date of Award
2014
Degree
Ph.D.
School
Public Health
Advisor
Peter Anderson
Abstract
Pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) are associated with adverse pregnancy outcomes including increased caesarean section rates, macrosomia, and perinatal mortality. Despite the high prevalence of GDM and PGDM in the Eastern Mediterranean Region (EMR), most of the published studies examining the association between GDM/PGDM and adverse pregnancy outcomes have small sample sizes, low statistical power, and few adverse outcomes with conflicting results. The purpose of this study was to determine the association of GDM/PGDM with adverse pregnancy outcomes among women in the EMR, by using a meta-analysis research design. Following the conceptual model of the epidemiologic triangle, the research questions for this study tested whether an association existed between GDM/PGDM and delivery by cesarean section, macrosomia, and perinatal mortality among women in the EMR. A random effects model was used for merging the weighted average of the odds ratios in the 33 primary studies. Pooling of the data showed that, in the EMR, odds of undergoing caesarean section, of having a macrosomic baby, and of perinatal death among women with GDM/PGDM were higher than those without GDM/PGDM. This study contributes to social change by providing a better picture of magnitude and severity of GDM/PGDM, in creating awareness of the seriousness of the problem, and in helping inform public health interventions in the EMR. Women with GDM/PGDM receiving proper health care can have decreased adverse outcomes which, in turn, results in healthy mothers and children forming a healthy family and leading to a healthy, productive community.
