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Cited by 181Gestational Diabetes Research and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Gestational Diabetes Mellitus in Europe: A Systematic Review and Meta-Analysis of Prevalence Studies

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Paulo, Marília Silva, Abdo, Noor Motea, Bettencourt-Silva, Rita, Al-Rifai, Rami H.·2021·Frontiers in Endocrinology
DOI 10.3389/fendo.2021.691033PMC PMC8698118
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Abstract

Background: Gestational Diabetes Mellitus (GDM) is defined as the type of hyperglycemia diagnosed for the first-time during pregnancy, presenting with intermediate glucose levels between normal levels for pregnancy and glucose levels diagnostic of diabetes in the non-pregnant state. We aimed to systematically review and meta-analyze studies of prevalence of GDM in European countries at regional and sub-regional levels, according to age, trimester, body weight, and GDM diagnostic criteria. Methods: Systematic search was conducted in five databases to retrieve studies from 2014 to 2019 reporting the prevalence of GDM in Europe. Two authors have independently screened titles and abstracts and full text according to eligibility using Covidence software. A random-effects model was used to quantify weighted GDM prevalence estimates. The National Heart, Lung, and Blood Institute criteria was used to assess the risk of bias. Results: From the searched databases, 133 research reports were deemed eligible and included in the meta-analysis. The research reports yielded 254 GDM-prevalence studies that tested 15,572,847 pregnant women between 2014 and 2019. The 133 research reports were from 24 countries in Northern Europe (44.4%), Southern Europe (27.1%), Western Europe (24.1%), and Eastern Europe (4.5%). The overall weighted GDM prevalence in the 24 European countries was estimated at 10.9% (95% CI: 10.0–11.8, I 2 : 100%). The weighted GDM prevalence was highest in the Eastern Europe (31.5%, 95% CI: 19.8–44.6, I 2 : 98.9%), followed by in Southern Europe (12.3%, 95% CI: 10.9–13.9, I 2 : 99.6%), Western Europe (10.7%, 95% CI: 9.5–12.0, I 2 : 99.9%), and Northern Europe (8.9%, 95% CI: 7.9–10.0, I 2 : 100). GDM prevalence was 2.14-fold increased in pregnant women with maternal age ≥30 years ( versus 15-29 years old), 1.47-fold if the diagnosis was made in the third trimester ( versus second trimester), and 6.79- fold in obese and 2.29-fold in overweight women ( versus normal weight). Conclusions: In Europe, GDM is significant in pregnant women, around 11%, with the highest prevalence in pregnant women of Eastern European countries (31.5%). Findings have implications to guide vigilant public health awareness campaigns about the risk factors associated with developing GDM. Systematic Review Registration: PROSPERO [ https://www.crd.york.ac.uk/PROSPERO/ ], identifier CRD42020161857.

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  • In Europe, the highest gestational diabetes mellitus prevalence was in Eastern Europe (31.5%) and the lowest in Northern Europe (8.9%); Western Europe was 10.7% and Southern Europe 12.3%.

    “The highest GDM prevalence was in Eastern Europe—31.5%, and the lowest was in Northern Europe—8.9%. The values for Western Europe and Southern Europe were 10.7% and 12.3%, respectively.”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [99]

  • According to a meta-analysis by Paulo et al., the overall weighted prevalence of gestational diabetes mellitus from 24 European countries was 10.9%.

    “According to a meta-analysis prepared by Paulo et al., the overall weighted prevalence of GDM from 24 European countries was 10.9%.”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [99]

  • In Europe, women age >30 years, overweight/obesity, and a gestational diabetes mellitus diagnosis in the third trimester were risk factors for increased prevalence of GDM.

    “Women age > 30 years, overweight/obesity, and a GDM diagnosis in the third trimester were risk factors for the increased prevalence of GDM [99].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [99]

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Cited by

Sorted by citations

Authors
Paulo, M. S., Abdo, N. M., Bettencourt-Silva, R., & Al-Rifai, R. H.
Affiliations
United Arab Emirates University (AE)
ORCID
Venue
Frontiers in Endocrinology
Publisher
Frontiers Media SA
Published
2021-12-09
Volume
12
Pages
691033-691033
ISSN
1664-2392 (ISSN-L)
DOI
10.3389/fendo.2021.691033
PMC
PMC8698118
OpenAlex
W4200446699
Cited by
181
References
20
Citations by year
2026: 30 · 2025: 47 · 2024: 45 · 2023: 41 · 2022: 18
FWCI
4.79
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)
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 › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
gestational diabetes mellitus, prevalence, pregnancy, maternal age, body mass index, GDM diagnostic criteria, NICE criteria, WHO criteria, European countries, regional variation, risk factors, maternal hyperglycemia, pregnancy outcomes, birth weight, neonatal hypoglycemia, neonatal jaundice, preterm birth, stillbirth, neonatal intensive care admission
MeSH terms
Adolescent, Adult, Cross-Sectional Studies, Europe, Female, Humans, Pregnancy, Risk Factors, Prevalence, Diabetes, Gestational, Young Adult

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