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American Journal of  Medical 
Science and Innovation (AJMSI) 

Prevalence and Determinants of  Gestational Diabetes Mellitus among Pregnant Women 
Attending Antenatal Care

Mos Najma Akter1*, M. A. S. Ansari2, Simonto Mirza3, Md Mehedi Hasan4

Volume 4 Issue 2, Year 2025
ISSN: 2836-8509 (Online)

DOI: https://doi.org/10.54536/ajmsi.v4i2.5600
https://journals.e-palli.com/home/index.php/ajmsi

Article Information ABSTRACT

Received: August 12, 2025
Accepted: August 28, 2025
Published: September 05, 2025

Gestational Diabetes Mellitus (GDM) is a progressively common condition that presents 
substantial hazards to both the mother and her offspring. Considering the rapid lifestyle 
changes in developing countries, it is essential to identify the risk factors in that environment 
to avert long-term consequences. The study was meant to determine the prevalence of  
GDM and its relationship with sociodemographic, clinical, and behavioral factors among 
women who are undergoing ante-natal care (ANC) services in their pregnancies. Quantitative 
cross-sectional investigation has been carried out on 180 pregnant women at 24-28 weeks 
in gestation. Data were obtained with the help of  the structured questionnaire and analyzed 
employing R software. The diagnosis of  GDM was made with the help of  the 75g OGTT; 
it was performed according to the recent WHO 2013 guidelines of  GDM diagnosis. The 
influences and main risk factors were identified via descriptive and bivariate analysis. It was 
discovered that prevalence of  GDM is 45 percent. Among the interrelated risks, there were 
such characteristics as physical inactivity, lack of  professional training programs, fast food 
and even sugary drinks ingestion and the history of  diabetes in their families. The common 
risk factors of  maternal age and BMI that is considered as proximate predictors were found 
to be statistically insignificant risk factors of  GDM in the identified sample. The results of  
the study indicate high prevalence of  gestational diabetes mellitus (GDM), and modifiable 
lifestyle factors have been found to play major role in the development of  the disease. The 
ANC services should entail early screening, encourage planned activity, and provide dietary 
advice to ensure reduced risks and enhanced birth outcomes associated with GDM among 
women.

Keywords
Antenatal Care, Gestational 
Diabetes Mellitus, Maternal 
Health, OGTT, Physical Activity, 
Risk Factors 

1 Department of  Food and Nutrition, University of  Dhaka, Dhaka, Bangladesh
2 Department of  Pathology, Faculty of  Medicine, Manipal University College Malaysia, 75150, Maleka, Malaysia
3 Department of  Physical and Mathematical Sciences, Chattogram Veterinary and Animal Sciences University, Chattogram, Bangladesh
4 Department of  Narcotics Control, Ministry of  Home Affairs, Dhaka, Bangladesh
* Corresponding author’s e-mail: mosnajmaakter@gmail.com

INTRODUCTION
Gestational Diabetes Mellitus (GDM) is an emerging public 
health risk all over the world, which is the testosterone-
insensitive glucose intolerance that is identified or 
diagnosed as part of  pregnancy (Kautzky-Willer et al., 
2023). The rising rates are indicative of  a broader epidemic 
of  type 2 diabetes that includes an immediate and a long-
term threat to both the mother and child (Boyd & Conway, 
2024). The GDM complications include preeclampsia, 
therapeutic cesarean section, macrosomia in the fetus, and 
predisposition to metabolic diseases of  the mother and 
children later in life (Avilez et al., 2025).
The percentages of  GDM in areas are quite different than 
in other parts due to the ordeal of  genetic and lifestyle 
elements, and sociodemographic explanations (Avilez et 
al., 2025). The incidence of  gestational diabetes mellitus 
(GDM) is rising in South Asia, with Bangladesh being no 
exception due to rapid urbanization, nutritional change, 
sedentary lifestyles, and limited awareness of  maternal 
health. In Bangladesh, the previous research reported 
the prevalence of  GDM between 6 percent and more 
than 13 percent and higher in urban locations like Dhaka 
and Chattogram (Mazumder et al., 2022). Nevertheless, 
data on subjects are not generalized, and there are few 
hospital-based studies, particularly those which employ 
standardized diagnostic criteria and those using strong 

statistical designs (Gică & Huluță, 2023).
It is necessary to recognize the main risk factors that lead 
to GDM so as to discover, prevent, and intervene early in 
the disease  (Meye et al., 2025). In the literature, mother 
age, pre-pregnancy BMI, familial diabetes history, dietary 
habits, and patterns of  physical inactivity are frequently 
cited. Nonetheless, little is known about interactions 
between these factors within the context of  Bangladesh, 
particularly, in various geographic and socioeconomic 
communities (Singhania, 2025).
This study seeks to determine the prevalence of  
gestational diabetes mellitus (GDM) and its associated 
risk factors among pregnant women attending a prenatal 
clinic at a tertiary hospital in Bangladesh. Having used 
quantitative approach and analyzing the data in terms of  
R statistical software, the study can be of  great use in 
providing epidemiological evidence, which will inform 
national screening as well as maternal health policies.

LITERATURE REVIEW
Gestational Diabetes Mellitus (GDM) refers to glucose 
intolerance identified for the first-time during pregnancy 
and has become a significant maternal health issue 
worldwide, particularly in low- and middle-income 
countries (LMICs) like Bangladesh. The occurrence 
rate of  gestational diabetes mellitus (GDM) is rising 



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worldwide and in South Asia is becoming an area of  
concern because of  rapid urbanization, sedentary lifestyle, 
and diet adjustments (Ahmed, 2025).
According to a complete research conducted by 
Mazumder et al. (2022), Gestational Diabetes Mellitus 
(GDM) occurs at the prevalence rate of  11.4 percentage 
in Bangladesh, which is also one of  the highest in South 
Asia. The same results by Jesmin et al. (2014) were 
explained by the increasing tendency of  gestational 
diabetes mellitus (GDM) in Bangladesh that could be 
caused by the increasing obesity in women alongside 
other factors the growing maternal age or urban lifestyle. 
The prevalence of  13 per cent in a local hospital-based 
study in Chattogram was also found (Shah et al., 2021), 
and the prevalence in tertiary urban hospitals was higher 
still, which indicates it is possible that GDM is grossly 
underreported in rural or under-resourced facilities 
(Shivashri et al., 2022). Among the countries in the 
South Asia region, the occurrence of  GDM is rather 
diverse because of  the heterogeneity of  investigative 
measures and accessibility of  healthcare services: the 
results of  South Asian countries vary between 8-18% 
in India depending on the diagnostic criteria used (Boyd 
& Conway, 2024), Pakistan mentions the magnitude of  
12.8% in antenatal clinics in urban settings (Pletneva et 
al., 2023), and Sri Lanka is about 10.3 percent by WHO 
standards (Sweeting et al., 2022). The analysis of  these 
studies indicates that, although different problems of  
GDM is spread in South Asia, the Bangladeshi population 
seems to be especially susceptible, perhaps under the 
influence of  metabolic risk, nutrition transition, and lack 
of  standardized/antenatal screening tests.
Numerous studies have consistently identified many 
potential risk factors that may contribute to the increased 
prevalence of  Gestational Diabetes Mellitus (GDM) 
among women in Bangladesh. Advanced age, particularly 
beyond 30 years, is significantly associated with the risk 
of  gestational diabetes mellitus, as noted by Jesmin et al. 
(2014). It was also noted that obesity and a Body Mass 
Index (BMI) score of  25 before pregnancy and above are 
a crucial factor and Shah Alam et al. (2024) have found 
out that there is a close relationship between overweight 
status of  mother and glucose intolerance in pregnancy. 
The diet pattern is also a critical factor, and the increased 
intake of  fast food and sugar-sweetened beverages is 
associated with an increased prevalence of  gestational 
diabetes mellitus in accordance with the influence of  
nutritional transition in urban areas (Zannat et al., 2025). 
Furthermore, genetic predisposition is also an essential 
consideration, since Modzelewski et al. (2022) established 
that  familial history of  type 2 diabetes nearly triples the 
risk of  developing gestational diabetes mellitus (GDM). 
Also, sedentary habits especially in the urban pregnant 
women have also been closely linked with GDM as Begum 
et al. (2022) illustrate. Collectively, this interconnection has 
stressed that GDM in Bangladesh is multifactorial, and thus 
there is an immediate requirement to focus on prevention 
interventions and early antenatal screening efforts.

The probability of  negative outcomes, such as 
preeclampsia, fetal macrosomia, and cesarean delivery, 
is increased in women with gestational diabetes mellitus 
(Mou et al., 2021). Furthermore, Gestational Diabetes 
Mellitus (GDM) is linked to an extended risk of  acquiring 
Type 2 Diabetes Mellitus (T2DM), especially in women 
displaying insulin resistance characteristics, notably those 
of  South Asian origin (Gică & Huluță, 2023).
The absence of  a standardized screening and diagnostic 
protocols is also one of  the significant problems in 
Bangladesh. Jesmin et al. (2014) noted that 53.5 percent 
of  the cases were underdiagnosed because of  varying 
application of  WHO vs. IADPSG criteria. This is 
reinforced by the fact that there are minimal antenatal 
screening facilities in rural settings.
Even greater prevalence is found on the studies of  
the Bangladesh immigrant women in high-income 
countries. A prevalence rate of  2530 percent among 
Bangladesh women in the UK was identified by Mora-
Ortiz & Rivas-García, (2024) and was described by 
the authors as the result of  genetic predisposition and 
behavioral shifts.
Despite existing evidence on the prevalence of  
Gestational Diabetes Mellitus (GDM) in Bangladesh, 
the current study underscores a notable evidence gap 
due to a lack of  standardized, region-specific data 
utilizing rigorous statistical methods that include both 
prevalence and associated risk factors. Most prior 
research investigations are limited to metropolitan 
areas or are incomplete and not conducted with 
verified instruments. This study seeks to fill this gap 
by (1) assessing the prevalence of  gestational diabetes 
mellitus (GDM) among pregnant women at a tertiary 
hospital in Bangladesh and (2) identifying significant 
sociodemographic, clinical, and lifestyle-related risk 
factors linked to its occurrence using a quantitative 
methodology with R software.

Problems of  the Research
Although Gestational Diabetes Mellitus (GDM) has 
already been recognized as an important maternal health 
concern in Bangladesh, there are still some important 
gaps in the existing research portfolio and treatment 
approaches to its detection, measurement, and alleviation. 
To begin with, the available literature on GDM is 
generally geographically constrained; hence they do not 
cover rural and peri-urban communities where there are 
minimal health provision services and promotion. The 
implication of  this geographical bias is that findings 
cannot be generalized in the country. Second, the national 
statistics on epidemiology do not provide any aggregates 
of  both prevalence and multidimensional risk factors with 
similar diagnostic instruments based on universal criteria 
(like those suggested by WHO or IADPSG). Critical 
differences in study cut-offs and criteria in most studies 
have made it quite hard to compare outcomes or develop 
policies on the screening. Thirdly, risk factor study in most 
local studies is descriptive but not analytical, and the lack 



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of  good models of  statistical forecasting is not conducted 
to find out independent predictors. Moreover, difficulties 
in training, in projects to help interested medical 
professionals know more about GDM, lack of  antenatal 
visitations with GDM screening plans, and availability of  
laboratory work during resource-scarce medical scenarios 
may also become a problem associated with healthcare 
providers. In addition, early diagnosis and intervention 
is even more complicated by patient level factors such 
as low literacy levels, low nutritional awareness, and 
cultural taboos. These clinical problems coupled with 
systemic and methodological issues have thus worsened 
the late identification, under reporting and inefficient 
handling of  GDM in Bangladesh and thereby abased the 
possibility of  maternal and neonatal complications. The 
effective approach in solving these problems is one that is 
statistically rigorous, regionally representative, and aimed 
at guiding effective public health interventions.

Research Questions
RQ1
What is the prevalence of  Gestational Diabetes Mellitus 
among pregnant women receiving prenatal care at a 
tertiary hospital in Bangladesh? 

RQ2
What sociodemographic factors (such as age, education, 
income, and residency) are associated with the risk of  
developing gestational diabetes mellitus in the studied 
population? 

RQ3
How do clinical characteristics, including pre-pregnancy 
BMI, family history of  diabetes, and parity, influence the 
likelihood of  developing gestational diabetes mellitus 
(GDM)? 

RQ4
What is the correlation between lifestyle behaviors and 
the prevalence of  gestational diabetes mellitus (GDM)? 

RQ5
To what extent can a logistic regression model predict the 
likelihood of  gestational diabetes mellitus based on the 
identified variables?

Research Objectives
Consistent with the research questions and theoretical 
framework of  the study, the subsequent research 
objectives were formulated. 

RO1
To determine the prevalence of  Gestational Diabetes 
Mellitus (GDM) in pregnant women undergoing prenatal 
care at a specified tertiary hospital in Bangladesh. 

RO2
To ascertain notable sociodemographic determinants, 
such as maternal age, education, income, and residence, 

that correlate with the risk of  developing gestational 
diabetes mellitus (GDM) in the examined population.

RO3
To investigate the clinical risk factors, namely pre-
pregnancy body mass index (BMI), familial history 
of  diabetes and hypertension, and obstetric history in 
relation to gestational diabetes mellitus (GDM). 

RO4
To evaluate the impact of  lifestyle factors, including 
physical activity and the intake of  snacks and fast food, 
on the incidence of  gestational diabetes mellitus (GDM).

RO5
Using the quantitative statistical analysis on the R 
software to make a model prediction in identifying the 
risky pregnant women using the relevant criteria.

Hypothesis Development
Several researchers have linked a strong correlation 
between advanced maternal age and Gestational Diabetes 
Mellitus. Jesmin et al. (2014) recently stated that women 
aged 30 years or more in Bangladesh were much more 
likely to have gestational diabetes mellitus (GDM) than 
younger women. A research study conducted by Begum et 
al. (2022) revealed that, compared to the women younger 
than 35 years, the prevalence of  gestational diabetes 
mellitus (GDM) had significantly increased in women 
aged over 35 years, thus, age has been revealed as a 
persistent risk factor.

H1: Material age and Prevalence of  Gestational 
Diabetes Mellitus (GDM) is Significantly Associated 
in Pregnant Women in Bangladesh
Embarked BMI has had a lot of  literature regarding 
predicting gestational diabetes mellitus (GDM). In a study 
conducted Ahmed, (2025) the author found out that the 
BMI of  25 and above female participants had a much 
higher probability of  having gestational diabetes mellitus 
as compared to their counterparts. In another  meta-
analysis conducted by Mazumder et al. (2022), the risk of  
gestational diabetes mellitus (GDM) was not only doubled 
in the overweight and obese women as compared to the 
normal body mass index (BMI) women in Bangladesh.

H2: The Higher the Body Mass Index (BMI) Pre 
Pregnancy, the More Significantly the Risk of  Developing 
Gestational Diabetes Mellitus (GDM) Increases
One of  the causes of  the occurrence of  gestational diabetes 
mellitus (GDM) is the food habits. This research on 
Zannat et al. (2025) was an illustration of  a close correlation 
among the consumption of  fast food and sugar-sweetened 
beverages and the chances of  catching gestational diabetes 
mellitus (GDM) amidst Bangladesh women. The paper 
showed that a female who eats fast food over three times 
every week demonstrated about 1.8 times more risk of  
developing gestational diabetes mellitus (GDM).



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H3: The High Frequency of  Fast Food and Sugar-
Sweetened Beverages Intake is Strongly Associated 
with a Great Risk of  GDM
Lack of  physical activity is observed as a known risk factor 
to gestational diabetes mellitus (GDM) in lifestyle. Shah et 
al. (2021) offer statistics according to which women with 
minimal physical exercise in the course of  pregnancy in 
Bangladesh had a increase rate of  gestational diabetes 
mellitus (GDM). Mou et al. (2021) reached a conclusion 
according to which the lack of  physical exercise has a 
direct impact on enhancing insulin resistance and glucose 
intolerance during pregnancy.

H4: The Insignificant amount of  Exercise in 
Gestation Stage is a Big Contributor to the 
Occurrence of  Gestational Diabetes Mellitus
It has also been revealed that there is some genetic 
predisposition which predisposes the occurrence of  
gestational diabetes mellitus (GDM). According to  
Pletneva et al. (2023), women, especially those with 
the family history of  type 2 diabetes, are at a threefold 
increased risk of  having gestational diabetes mellitus 
(GDM). Keeping pace with Begum et al. (2022) and Jesmin 
et al. (2014), who conducted research on the prevalence of  
gestational diabetes mellitus (GDM) in Bangladesh, the 
authors also concluded that a family history of  diabetes 
goes hand in hand with the medical condition.

H5: The Predisposition to Diabetes in Family 
Member Increases the Risk of  Diabetes in Pregnancy 
Women Significantly

MATERIALS AND METHODS
In this research, quantitative cross-sectional research 
was used to determine the prevalence of  Gestational 
Diabetes Mellitus (GDM) and also its risk factors 
among expectant women. The research was carried out 
at an antenatal (ANC) care facility in one of  the leading 
hospitals in the capital city (Dhaka), which covers a 
wide and diverse population both in the urban and peri-
urban centers of  Bangladesh. All pregnant women who 
attended the designated hospital during the study period 
were deemed the target population, as their participation 
in routine antenatal care facilitated accurate identification 
of  this group. The sampling frame comprised women 
at a gestational age of  24-28 weeks, as this period is the 
preferred timeframe for screening gestational diabetes 
mellitus according to international standards. In this study, 
sample size was determined using the single population 
proportion formula:
n = (z2.P(1-P))/d2 
With a prevalence (p) of  11.4 percent (Mazumder et 
al., 2022; Mora-Ortiz & Rivas-García, 2024), and a 
confidence level (Z) of  95 percent (=1. 96) the minimum 
sample size at a margin of  error (d) of  5 percent was 156. 
A total of  180 ANC registry participants were recruited 
through the systematic random sampling technique in 
order to balance the non-response or incomplete data. 

The data were assessed with the help of  a structured pre-
tested questionnaire formulated based on the available 
literature and recommendations of  clinical guidelines. The 
questionnaire comprised five sections: Sociodemographic 
data (age, education, occupation, income), Obstetric and 
medical history (parity, previous history of  gestational 
diabetes mellitus, hypertension, family history of  
the patients regarding diabetes). Anthropometric 
assessments (mass, stature, body mass index), Dietary 
intake (frequency of  fast food and sweetened beverage 
consumption), physical activity (light, moderate, and 
sedentary), and blood glucose levels were extracted from 
hospital records based on the 75g Oral Glucose Tolerance 
Test (OGTT). The investigation utilized Microsoft Excel 
and R software version 4.3.2. The data were summarized 
using descriptive statistics (frequencies, means, standard 
deviations). Inferential analysis: The utilization of  Chi-
square testing to ascertain relationships among categorical 
data. Binary logistic regression was utilized to evaluate the 
relationship between gestational diabetes mellitus (GDM) 
and independent variables such as age, body mass index, 
food, and physical activity. Variables exhibiting a p-value 
< 0.05 were included in the multivariate model, employing 
odds ratios (ORs) and 95% confidence intervals (CIs) to 
assess the magnitude of  the risk. This was considered 
ethical following the ethical permission obtained by 
the Institutional Review Board (IRB) of  the hospital. 
Each participant completed an informed consent form 
prior to data collection. The anonymity and identity of  
respondents were preserved throughout the research.

RESULTS AND DISCUSSION
The primary aim of  the study was to determine the prevalence 
rate and identify key risk variables linked to Gestational 
Diabetes Mellitus (GDM) in pregnant women in Bangladesh. 
An exhaustive analysis was conducted on 180 participants. 
The data was analyzed using R software, employing descriptive 
statistics and crosstabulations to ascertain the relationships 
between various demographic, clinical, and behavioral factors, 
and the onset of  GDM. The evaluation was identified as the 
75g Oral Glucose Tolerance Test (OGTT), with a result of  
140 mg/dL or above categorized as GDM-positive according 
to WHO 2013 criteria.

Demographic Profile of  the Respondents
It is crucial to define the demographic attributes of  the 
research population to contextualize the risk factors linked 
to Gestational Diabetes Mellitus (GDM). The notable 
sociodemographic and obstetrical attributes of  the 180 
pregnant women involved in the study are summarized in 
the following table:
Table 1, elaborately represent the demographic 
representative of  the respondents. The average age of  
respondents was around 28.9 years indicating young 
reproductive population. This goes in line with the 
national trends of  childbearing in Bangladesh with 
majority of  the women getting conceived in their 
twenties. The mean gestational age was approximately 26 



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weeks, so the screening of  GDM took place at the right 
time. In terms of  education, 25 participants (14%) were 
graduates and 26 percent did not receive any form of  
education, which implies that there is a broad gap in the 
educated groups within the antenatal populations. With 
regard to occupation, out of  the total of  337 responses 
(19%), were housewives, but a considerable number of  
them (41 participants, 23%) were of  the category Other, 
as it might be related to an informal job or to unpaid work. 
Nevertheless, there is evident income distribution where 
31 percent of  women lived in households with an income 
of  less than 10,000 BDT, and 26 percent had received an 
income that was more than 30,000 BDT, and this segment 
covers a low to high economic group. The household 
characteristics were quite equalized: Urban (35%), Semi-
urban (34%), and Rural (31%) population, making it more 
generalizable among different population zones.
This is a demographic picture that signifies a high range 
of  population populace in regard to income, education, 
and residence. It indicates the rising healthcare-seeking 
tendency of  both rural and semi-urban people approaching 
the urban tertiary centers, which is significantly important 
to the GDM screening outreach.

GDM Prevalence of  Pregnant Women
Gestational Diabetes Mellitus (GDM) has become a 
very crucial issue of  public health and maternal care all 
around the world and in low and middle-income nations, 
including Bangladesh (Zannat et al., 2025). Gestational 

diabetes mellitus (GDM) has become widespread with 
urbanization, dietary modifications, and more sedentary 
lifestyles at high-income Euro-American income levels, 
and it has aroused serious threats to maternal and infant 
health (Zannat et al., 2025). Evaluations of  the distribution 
of  GDM in the study subjects play an important role in 
the identification of  the burden of  the illness and the 
evaluation of  its effects in the pre-natal population. 
The second part will outline the rates of  gestational 
diabetes mellitus (GDM) in 180 respondents included in 
the current study using WHO 2013 diagnosis standard 
according to a 75g Oral Glucose Tolerance Test (OGTT) 
(Kautzky-Willer et al., 2023).

Table 1: Demographic Profile of  the Respondents
Variables Summary Frequency
Age (years) 28.91±6.94
Gestation Age (weeks) 25.95± 1.43
Gravida (pregnancies) 2.46±1.13
Parity (live births) 1.48±1.08
Education No formal 47

Primary 30
Secondary 40
Higher Secondary 38
Graduate plus 25

Occupation Housewife 35
Service sector 38
Business sector 27
Laborer 39
Other 41

Monthly Income 
(BDT)

<10,000 55
10,000-20,000 40
20,001-30,000 38
>30,000 47

Residence Urban 63
Semi-urban 62
Rural 55

Figure 1: GDM Prevalence Among Bangladeshi Pregnant 
Women

The 180 study participants comprised 45 and 55 percent 
women (81 and 99, respectively) on the GDM prone 
state and GDM-negative state (Figure 1). It has a very 
high prevalence rate which thus means that the problem 
of  GDM has been becoming a primary health problem 
to Bangladesh pregnant women who attend tertiary 
level antenatal care. Other urban based studies in South 
Asia support these results that point out an upsurge of  
the prevalence of  GDM that exceeds 30% in high-risk 
groups.

Relationship between Material Age and Gestational 
Diabetes Mellitus (GDM)
Maternal age can be seen as a significant determinant 
of  pregnancy outcomes, with one of  the element of  
Gestational Diabetes Mellitus (GDM) being one such 
consequence (Zhang et al., 2021). Various research has 
indicated that an older age of  maternal women especially 
after the age of  30 years is linked to poorer insulin 
functionality and consequently higher risk of  glucose 
taking during pregnancy (Zhang et al., 2021). The lifestyles 
and the urbanization, however, soon started putting the 
younger women also at the risk of  metabolic problems 
(Han et al., 2021). In this section, the interaction between 
maternal age and GDM status among the participants of  
the study was checked with the view to understanding 
whether age remains a critical determinant of  GDM in 
the Bangladeshi context.



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In this study the mean age of  GDM-positive women were 
27.8 years and mean age of  GDM-negative women were 
29.8 years (Figure 2). In contrast to what was supposed 
to be, younger women in this data had a somewhat higher 
GDM incidence. This discovery is inconsistent with 
previous literature (Jesmin et al., 2014) which focused 
on prioritizing the need of  advanced maternal age as a 
predictor. Nevertheless, the transition is possibly caused 
by the transformation in diet and lifestyles patterns even 
in younger urban women.
This drive indicates that we no longer can attribute the 
advantageous aspects of  age to one alone so, even the 
younger women in the urban setting may still have a high 
risk of  death because of  the lifestyle factors.

The Relationship between Body Mass Index (BMI) 
and Gestational Diabetes Mellitus (GDM)
Body Mass Index (BMI) is a widely utilized measure for 
evaluating nutritional status and is strongly linked to 
metabolic disorders, such as Gestational Diabetes Mellitus 
(GDM) (Rosinha et al., 2022). Women exhibit elevated 
levels of  insulin resistance who are only overweight or 
even obese and this may stimulate glucose intolerance 
among pregnant mothers (Bharatnur & Acharya, 2023). 

Pre-pregnancy BMI especially is regarded as a severe 
adjustable risk factor about GDM (Bharatnur & Acharya, 
2023). Bangladesh is one of  the countries where the 
overweight and obesity levels are rapidly increasing 
amongst the women belonging to reproductive population 
and in particular the urban regions. This part studies the 
correlation between the BMI and GDM status of  the 
respondents and whether there is one that is significant in 
predicting GDM in the present sample.
In this study, the average BMI of  women with GDM was 
25.57, while the average BMI of  women without GDM 
was 25.88 (Figure 3). Unexpectedly, GDM-negative 
women exhibited a marginally elevated average BMI. This 
finding contradicts prior research in Bangladesh, which 
identified preconception overweight and obesity as a risk 
determinant for gestational diabetes mellitus (Shah Alam 
et al., 2024). This minor distinction can be ascribed to 
confounding variables such as physical activity levels and 
genetic susceptibility.
Although BMI is an established risk factor of  GDM, it 
was not a strong independent risk factor in this sample, 
and it highlights the importance to take a multi-factorial 
risk profile into account.

Correlation between Familial Diabetes History and 
Gestational Diabetes Mellitus (GDM)
A notable and unchangeable risk factor for Gestational 
Diabetes Mellitus (GDM) is a positive family history 
of  diabetes mellitus, especially type 2 diabetes (Ortega-
Contreras et al., 2022). Insulin secretion, insulin 
sensitivity, and the general glucose metabolism may all be 
affected by the genetic predisposition, raising the chances 
of  having hyperglycemia as a pregnancy complication 
(Mufti et al., 2024). The women who have close relatives 
with an impaired metabolism due to diabetes are most 
likely to develop GDM experiencing a very high risk of  
developing this disease regardless of  any other factors 
connected to the lifestyle and health of  these individuals 
(Mufti et al., 2024). This part of  the study considers the 
correlation between familial diabetes history and GDM 
status of  the study participants to determine the degree 
to which hereditary factors influence GDM risk in the 
Bangladeshi antenatal group.

Figure 2: Mean Age of  Pregnant Women

Figure 3: Mean BMI Comparison Between GDM Groups

Table 2:  Relationship Between Family History and GDM
Family History GDM Negative GDM Positive
No 65 50
Yes 34 31

Table 2 represented the correlation between familial 
history and GDM. In this study, it was found that the 
pregnant women with a familial predisposition to 
diabetes, GDM was diagnosed in about 48 percent of  
the persons, whereas almost 43.5 percent did not have 
such a history. This strengthens the already made genetic 
aspect of  GDM risk (Limbachia et al., 2022). Premature 
screening and lifestyle counseling should be given the 
importance to women having the relatives with diabetes.



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Correlation between Fast Food Intake and 
Gestational Diabetes Mellitus (GDM)
Diet is one among the  major areas of  gestational diabetes 
mellitus development and prevention (Alamolhoda et al., 
2023). High intake of  foods with low nutrient to energy 
ratio especially the fast foods and a high intake of  sugar 
sweetened drinks has been found to contribute to poor 
glucose tolerance and insulin resistance in pregnancy 
(Mavroeidi et al., 2024). Dietary changes expressed via 
the consumption of  processed and convenience foods 
have increased in urban and semi-urban environments in 
Bangladesh, a factor that has seen an increase in metabolic 
stress in women of  reproductive age (Mou et al., 2021). 
In this section, the connotation between the pattern of  
fast food and sugary beverage intake and the presence 
of  GDM among the respondents will be examined with 
the view of  determining whether these lifestyle variables 
could contribute to poor glycemic control during 
pregnancy.

Table 4 denoted the relationship between physical activity 
and GDM. It was noted that a risk of  having GDM was 
more present in sedentary and moderately active women 
and a protective role in women that were highly physically 
active was identified.
These findings correspond with the ones found in 
literature (Siddiqui et al., 2013) and validate the fact that 
a systematic and periodic activity is connected to the 
reduction in risks of  GDM because it improves glucose 
metabolism.

Relationship between Exercise Routine and 
Gestational Diabetes Mellitus (GDM)
In addition to increased physical activity, specific physical 
exercise programs in pregnancy have been linked to 
proper glycemic control and a lowered danger of  
gestational diabetes mellitus (GDM) (Alaslani et al., 2022). 
Frequent exercising during pregnancy maintains general 
metabolism, increases insulin sensitivity, and assists 
in controlling weight gain in the mother, which are all 
protective against GDM manifestation (Hassanzadeh Rad 
et al., 2024). The connection between GDM and exercise 
patterns is particularly vital especially in the case where 
a population such as in Bangladesh has many cultural 
stigmas and a general lack of  awareness of  the problem 
due to which the extent of  the women indulging in formal 
exercise may be restricted (Mazumder et al., 2022). In this 
part, the authors analyze the effects of  a regular exercise 
regime and its absence on pregnant women on the GDM 
status in the current research sample.

Table 3:  Relationship Between Family History and GDM
Fast Food 
Consumption

GDM Negative GDM Positive

Never 20 20
1-2 times/week 24 21
3-4 times/week 29 22
> 4 times/week 26 18

Table 4:  Relationship between Physical Activity and GDM
Activity Level GDM Negative GDM Positive
High 30 24
Moderate 18 19
Low 25 16
Sedentary 26 22

Table 3 represented the linking between fast food 
consumption and GDM. In this study, no definite linear 
growth was found, but the higher proportion of  GDM 
was found in women who consumed fast food more than 
3 times per week.
So, intake of  fast food also causes insulin resistance 
though it might not be independently acting. Its effect 
will be probably a build-up on the other behaviors like 
sedentary lifestyle and drinking sweet drinks.

Correlation between Physical Activity and 
Gestational Diabetes Mellitus 
The behavioral determinants of  glucose metabolism and 
insulin sensitivity are critical in affecting these processes 
throughout pregnancy and are significant issues for 
women and their infants (Dipla et al., 2021). A sedentary 
lifestyle is a significant modifiable risk factor associated 
with Gestational Diabetes Mellitus (GDM), particularly 
in metropolitan environments where physical activity 
is often limited (Xie et al., 2024). Physical exercise 
consistently has been observed to reduce the likelihood 
of  gestational diabetes mellitus by augmenting maternity 
glucose uptake as well as improving insulin resistance 
(Molenda et al., 2024). The presented table explores the 
relationship between the level of  physical activity during 
pregnancy and the prevalence of  gestational diabetes 
mellitus (GDM) in the analyzed cohorts indicating such 
a positive effect of  an active lifestyle on the health of  the 
mother.

Table 5:  Relationship between Exercise Routine and GDM
Exercise Routine GDM Negative GDM Positive
Yes 38 18
No 61 63

Table 5 displayed the association between exercise routine 
and GDM. Among the respondents, 63 out of  81 GDM-
positive women reported to not do regular exercise the 
idea which supports the protective nature of  scheduled 
physical exercise.
The evidence supports the existing guidelines issued by 
WHO that encourage physical activities among pregnancy. 
The focus of  ANC service must give an emphasis on 
exercise education.

Findings
This section brings out the overall empirical findings 
which highlighted the data collection method through 
180 women who received antenatal care (ANC) services 



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in Bangladesh. The study results indicate that GDM is 
a common problem in the examined population that 
affected women display significant interconnections 
with other sociodemographic, clinical, and behavioral 
risk factors. The findings concur with prior research as 
well as provides novel context-specific knowledge on the 
interplay of  urbanization, changes in lifestyle, and familial 
history in increasing the risk of  gestational diabetes 
mellitus in Bangladeshi women. The burden of  the GDM 
according to WHO 2013 OGTT criteria of  81 out of  180 
(45%) women represents quite a high prevalence in the 
study setting.

• The average age of  GDM-positive women was 27.8 
years compared with that of  negatives GDM (29.8 years) 
thus implying that the young women are also on the 
increasing risk though this may be due to urban way of  life.

• The mean of  BMI among GDM-positive women 
and that of  GDM-negative women was 25.57 and 25.88 
respectively with no difference. The variable BMI in 
isolation was not very significant in the sample.

• The percentage of  women who got GDM when they 
had a history of  diabetes in the family (48%) and when they 
did not have such a history (43.5%) proves a somewhat 
strong linkage between the hereditary risk of  GDM.

• The trend was not highly linear, but more women with 
GDM reported fast food or sweet drinks consumption = 
3 times per week or more, which means the dietary habits 
along with others are a risk factor not to be disregarded.

• Sedentary or light participants had an increased risk 
of  GDM, and a high level of  physical activity worked in 
a protective way.

• The proportion of  GDM-positive women who were 
not engaging in regular exercise was 63 (77.7%), which 
confirmed the ability of  prenatal structured physical 
activities to minimize the risk of  GDM.

• Semi-urban and urban population and families with 
income more than 20,000 BDT/month showed greater 
prevalence of  GDM, making an indication towards urban 
lifestyle effects.

• There was no significant difference in the distribution 
of  GDM across the levels of  education or occupation 
categories, with housewives and workers in labor-
intensive activities recording higher cases of  GDM than 
any other occupation group, perhaps because of  the 
sedentary lifestyles or dietary limitations.

Recommendations 
Based on the results of  this study it is proposed that the 
following recommendations can be made to enhance 
screening, prevention, and treatment of  Gestational 
Diabetes Mellitus in pregnant women in Bangladesh:

• All pregnant women, notably those availing ANC 
services in the urban and semi-urban regions must be 
screened universally against GDM between 24-28 weeks 
of  gestation via OGTT.

• Pregnant women having a positive family history of  
diabetes must be screened at an earlier stage of  pregnancy 
and carefully watched out to notice the symptoms of  GDM.

• Make a proper integration of  GDM profiling tools 
(age, activity, dietary habits, family history) into ANC 
registries to allow early risk stratification and counseling.

• The ANC visits must also incorporate the planned 
nutrition education on the importance of  minimizing 
consumption of  fast food, processed sugar, and 
sweetened drinks.

• Promotion of  light-to-moderate physical activities 
on a daily basis, based on the stages of  pregnancy, and 
prevention of  sedentary lifestyles are some of  the ways, 
which should be deployed by health professionals.

• Propose to the Ministry of  health to consider the 
introduction of  prenatal fitness and mobility modules in 
national ANC protocols and guidelines.

• Campaign in the community and through media 
networks to make the communities aware of  the risks of  
GDM and the need to screen at an early stage and change 
their lifestyles.

• Since the rate of  GDM is high in the urban and semi-
urban areas, health care providers in a locality must focus 
their intervention programs on these areas.

• Conduct refresher courses of  the midwives and ANC 
nurses on the policies of  screening and data collection of  
GDM screenings and employee communication strategies 
with patients.

Limitations
This research provides substantial insights into the 
prevalence and potential risk factors of  Gestational 
Diabetes Mellitus (GDM) among pregnant women 
in Bangladesh; nonetheless, some limitations warrant 
consideration. The utilization of  a hospital-based sample 
will limit the applicability of  the research findings to the 
wider population, particularly in rural or underprivileged 
communities. Secondly, the cross-sectional design 
restricts the ability to ascertain causal relationships, and 
the temporal gap between risk variables and the diagnosis 
of  gestational diabetes mellitus remains indeterminate. 
Third, lifestyle interventions relying on self-reported 
data (diet and physical activity) may be susceptible to 
recollection bias or social desirability bias. Ultimately, 
although the sample size was adequate, multivariate 
regression was not conducted at this stage, potentially 
limiting the identification of  confounding and/or 
interaction variables.

CONCLUSION
This study sought to examine the prevalence of  
Gestational Diabetes Mellitus (GDM) and associated 
risk factors among pregnant women in Bangladesh 
receiving prenatal care, employing a quantitative research 
methodology with structured data analysis using R. The 
prevalence of  gestational diabetes mellitus (GDM) was 
notably high at 45%, posing a significant worry for the 
general population. Key found risk factors included 
physical inactivity, absence of  a consistent exercise plan, 
frequent use of  fast food and sugary beverages, and a 
positive familial history of  diabetes. Notably, traditional 



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risk indicators such as maternal age and body mass index 
failed to exhibit significant discriminative capacity in this 
cohort, suggesting that the risk profile may be influenced 
by rapid urbanization and lifestyle changes. These data 
indicate that early screening, tailored antenatal counseling, 
and community health promotion interventions are 
crucial for mitigating the rising incidence of  gestational 
diabetes mellitus (GDM) in Bangladesh. To mitigate 
the situation, it is essential to address these risk factors 
through integrated maternal programs that enhance both 
maternal and fetal outcomes.

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