Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000-2019: A Systematic Review, Meta-Analysis, and Meta-Regression.
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%, I2 , 99.3%). Nationally, GDM was highest in Qatar (20.7%, 95% CI, 15.2-26.7% I2 , 99.0%), whereas subregionally, GDM was highest in Gulf Cooperation Council (GCC) countries (14.7%, 95% CI, 13.0-16.5%, I2 , 99.0%). The prevalence of GDM was high in pregnant women aged ≥30 years (21.9%, 95% CI, 18.5-25.5%, I2 , 97.1%), in their third trimester (20.0%, 95% CI, 13.1-27.9%, I2 , 98.8%), and who were obese (17.2%, 95% CI, 12.8-22.0%, I2 , 93.8%). The prevalence of GDM was 10.6% (95% CI, 8.1-13.4%, I2 , 98.9%) in studies conducted before 2009, whereas it was 14.0% (95% CI, 12.1-16.0%, I2 , 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.
PROSPERO CRD42018100629.
Al-Rifai RH
，Abdo NM
，Paulo MS
，Saha S
，Ahmed LA
... -
《Frontiers in Endocrinology》
Prevalence of type 2 diabetes mellitus in women of childbearing age in Africa during 2000-2016: a systematic review and meta-analysis.
The aim of this research was to estimate the prevalence of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), in African women of childbearing age.
Systematic review and meta-analysis of relevant African studies published from January 2000 to December 2016.
We searched several databases, including EMBASE, MEDLINE, CINAHL, grey literature and references of included studies.
Studies carried out in African communities or any population-based studies were included.
We included studies, carried out in Africa, with non-pregnant women of childbearing age. Studies must have been published between the years 2000 and 2016.
The primary outcome was prevalent T2DM. The secondary outcomes were IFG and IGT.
Two reviewers independently extracted data and, using the adapted Hoy risk of bias tool, independently assessed for risk of bias. We used random-effects meta-analysis models to pool prevalence estimates across studies. We used Cochran's Q statistic and the I2 statistic to assess heterogeneity.
A total of 39 studies from 27 countries were included, totaling 52 075 participants, of which 3813 had T2DM. The pooled prevalence of T2DM was 7.2% (95% CI 5.6% to 8.9%) overall and increased with age. The pooled prevalence was 6.0% (95% CI 4.2% to 8.2%) for impaired fasting glycemia while the prevalence of IGT ranged from 0.9% to 37.0% in women aged 15-24 and 45-54 years, respectively. Substantial heterogeneity across studies was not explained by major studies characteristics such as period of publication, rural/urban setting or whether a study was nationally representative or not.
This review highlights the need for interventions to prevent and control diabetes in African women of childbearing age, in view of the significant prevalence of T2DM and prediabetes.
CRD42015027635.
Chivese T
，Werfalli MM
，Magodoro I
，Chinhoyi RL
，Kengne AP
，Norris SA
，Levitt NS
... -
《BMJ Open》
Prevalence of type 2 diabetes mellitus in women of childbearing age in Africa during 2000-2016: protocol of a systematic review and meta-analysis.
African women of childbearing age are increasingly being exposed to risk factors for type 2 diabetes mellitus (T2DM), most particularly obesity. A differentiating feature of diabetes in women of childbearing age is that the disease may affect the mother and the developing fetus. Apart from mapping the extent of the problem, understanding the prevalence of T2DM in African women of childbearing age can help to galvanise targeted interventions for reducing the burden of T2DM. This is a protocol for a systematic review aiming to assess the prevalence of and risk factors for T2DM in women of childbearing age (15-49 years) in Africa.
We will carry out a comprehensive literature search among a number of databases, using appropriate adaptations of the African search filter to identify diabetes prevalence studies, published from 2000 to 2016, among African women of childbearing age (15-49 years) according to the WHO definition. Full copies of articles identified through searches and considered to meet the inclusion criteria will be obtained for data extraction and synthesis. The analysis of the primary outcome (prevalent diabetes) will include two steps: (1) identification of data sources and documenting estimates and (2) application of the random-effects meta-analysis model to aggregate prevalence estimates and account for between-study variability in calculating the overall pooled estimates and 95% CI for diabetes prevalence. We will assess heterogeneity and publication bias using established methods. This systematic review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocol (PRISMA-P) 2015.
Ethical approval is not required for this study, given that this is a protocol for a systematic review, which utilises published data. The findings of this study will be widely disseminated through peer reviewed publications and conference presentations.
CRD42015027635.
Chivese T
，Mahmoud W
，Magodoro I
，Kengne AP
，Norris SA
，Levitt NS
... -
《BMJ Open》
ResearchGate
(全网免费下载)
钛学术
(全网免费下载)
