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Cited by 78Gestational Diabetes Research and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsMaternal and Neonatal Healthcare

Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000–2019: A Systematic Review, Meta-Analysis, and Meta-Regression

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Al-Rifai, Rami H., Abdo, Noor Motea, Paulo, Marília Silva, Saha, Sumanta, Ahmed, Luai A.·2021·Frontiers in Endocrinology
DOI 10.3389/fendo.2021.668447PMC PMC8427302
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Abstract

Women in the Middle East and North Africa (MENA) region are burdened with several risk factors related to gestational diabetes mellitus (GDM) including overweight and high parity. We systematically reviewed the literature and quantified the weighted prevalence of GDM in MENA at the regional, subregional, and national levels. Studies published from 2000 to 2019 reporting the prevalence of GDM in the MENA region were retrieved and were assessed for their eligibility. Overall and subgroup pooled prevalence of GDM was quantified by random-effects meta-analysis. Sources of heterogeneity were investigated by meta-regression. The risk of bias (RoB) was assessed by the National Heart, Lung, and Blood Institute’s tool. One hundred and two research articles with 279,202 tested pregnant women for GDM from 16 MENA countries were included. Most of the research reports sourced from Iran (36.3%) and Saudi Arabia (21.6%), with an overall low RoB. In the 16 countries, the pooled prevalence of GDM was 13.0% (95% confidence interval [CI], 11.5–14.6%, I 2 , 99.3%). Nationally, GDM was highest in Qatar (20.7%, 95% CI, 15.2–26.7% I 2 , 99.0%), whereas subregionally, GDM was highest in Gulf Cooperation Council (GCC) countries (14.7%, 95% CI, 13.0–16.5%, I 2 , 99.0%). The prevalence of GDM was high in pregnant women aged ≥30 years (21.9%, 95% CI, 18.5–25.5%, I 2 , 97.1%), in their third trimester (20.0%, 95% CI, 13.1–27.9%, I 2 , 98.8%), and who were obese (17.2%, 95% CI, 12.8–22.0%, I 2 , 93.8%). The prevalence of GDM was 10.6% (95% CI, 8.1–13.4%, I 2 , 98.9%) in studies conducted before 2009, whereas it was 14.0% (95% CI, 12.1–16.0%, I 2 , 99.3%) in studies conducted in or after 2010. Pregnant women in the MENA region are burdened with a substantial prevalence of GDM, particularly in GCC and North African countries. Findings have implications for maternal health in the MENA region and call for advocacy to unify GDM diagnostic criteria. Systematic Review Registration PROSPERO CRD42018100629

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Crossref · 10.3389/fendo.2021.668447

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  • In North Africa, the weighted incidence of gestational diabetes mellitus was 13.5% (95% CI: 7.4-20.9, I2 = 98.9%).

    “The weighted incidence of GDM in North Africa was 13.5% (95% CI: 7.4–20.9, I2 = 98.9%).”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [40]

    The Results section, “Subregional Specific Pooled GDM Prevalence,” gives the North African estimate as 13.5% (95% CI, 7.4–20.9%; I², 98.9%). It identifies this as weighted prevalence, not incidence; the cited paper therefore supports the figures but not the measure named in the claim. (LLM, conf=0.88)

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  • The gestational diabetes mellitus prevalence in North African countries with a maternal mortality ratio >100/100,000 live births was 32% higher than in those with an MMR ≤100/100,000.

    “This prevalence was 32% higher in North African countries with a maternal mortality ratio (MMR) > 100/100,000 live births than in North African countries with an MMR ≤ 100/100,000 live births [40].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [40]

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4 of the 145 references couldn’t be matched to a known paper.

Research works printed but not linked: 7

  1. [1]Quintanilla Rodriguez BS Mahdy H. Gestational Diabetes. In: StatPearls. Treasure Island (FL) (2020). 31424780
  2. [4]Hod M Kapur A Sacks DA Hadar E Agarwal M Di Renzo GC. The International Federation of Gynecology and Obstetrics (FIGO) Initiative on Gestational Diabetes Mellitus: A Pragmatic Guide for Diagnosis, Management, and Care(). Int J Gynaecol Obstet (2015) 131(Suppl 3): S173–211. 10.1016/S0020-7292(15)30033-3 26433807 · DOI · Paper page
  3. [11]International Diabetes Federation. IDF Diabetes Atlas 6th Edition (2013). Available at: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/19-atlas-6th-edition.html (Accessed June 3, 2020).
  4. [15]Covidence. Covidence – Better Systematic Review Management. Melbourne, Victoria, Australia: Covidence (2018). Available at: https://www.covidence.org/home.
  5. [38]Mohammed AK Algani VHA. The Correlation Between Serum Ferritin and Fasting Blood Sugar in Iraqi Women With Gestational Diabetes. J Pharm Sci (2017) 9(9): 1654–8.
  6. [42]Abolfazl M Hamidreza TS Narges M Maryam Y. Gestational Diabetes and its Association With Unpleasant Outcomes of Pregnancy. Pak J Med Sci (2008) 24(4): 566–70.
  7. [105]Almarzouki AA. Pregnancy Outcome With Controlled Gestational Diabetes: A Single Centre Experience. Pak J Med Sci (2012) 28(5): 887–90.

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Authors
Al-Rifai, R. H., Abdo, N. M., Paulo, M. S., Saha, S., & Ahmed, L. A.
Affiliations
  • United Arab Emirates University (AE)
  • R. G. Kar Medical College and Hospital (IN)
ORCID
Venue
Frontiers in Endocrinology
Publisher
Frontiers Media SA
Published
2021-08-26
Volume
12
Pages
668447-668447
ISSN
1664-2392 (ISSN-L)
DOI
10.3389/fendo.2021.668447
PMC
PMC8427302
OpenAlex
W3193915413
Cited by
78
References
145
Citations by year
2026: 17 · 2025: 12 · 2024: 23 · 2023: 16 · 2022: 9 · 2021: 1
FWCI
2.26
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Endocrinology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Greater South Information System
Funders
United Arab Emirates University
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
gestational diabetes mellitus, prevalence, Middle East and North Africa, maternal obesity, maternal age, parity, third trimester, risk factors, regional variation, Gulf Cooperation Council, pregnancy outcomes, maternal mortality, neonatal outcomes, maternal morbidity, risk of bias, risk of bias assessment, risk of bias adjustment
MeSH terms
Africa, Northern, Female, Humans, Middle East, Pregnancy, Risk Factors, Prevalence, Diabetes, Gestational

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