Gestational diabetes mellitus and its associated factors among women of advanced maternal age in Malaysia: Findings from a national survey

Abstract

Gestational diabetes mellitus (GDM) is a growing public health concern, particularly among women with advanced maternal age. Understanding the prevalence and associated sociodemographic factors is crucial for targeted interventions. This study aimed to determine the prevalence of GDM and its association with sociodemographic factors among Malaysian women with advanced maternal age. This study utilized data from the National Health and Morbidity Survey 2022: Maternal and Child Health, a nationwide cross-sectional survey employing a two-stage stratified cluster sampling design. GDM was identified based on the result of a modified oral glucose tolerance test (MOGTT) recorded in the mother’s antenatal book. The 75-g MOGTT was performed according to the Clinical Practice Guidelines for the Management of Diabetes in Pregnancy in Malaysia. Sociodemographic variables, including ethnicity, locality, education, employment, and household income, were analysed. Multiple logistic regression was performed to identify factors associated with GDM. The prevalence of GDM among women with advanced maternal age in Malaysia was 33.7% (95% CI: 30.9%−36.5%). Ethnicity was significantly associated with GDM, with Indian women showing the highest prevalence (48.8%) and odds (AOR: 7.31, 95% CI: 2.58–20.72; P<0.001). Working status was another significant factor, with non-working women having higher odds of GDM compared to working women (AOR: 1.34, 95% CI: 1.01–1.77; P=0.003). No significant associations were observed for locality, educational level, or household income. The high prevalence of GDM among women with advanced maternal age in Malaysia underscores the urgent need for targeted interventions, particularly among high-risk ethnic groups. Public health strategies should prioritize early screening, culturally tailored programs, and community-based initiatives to address this growing burden. Future research should explore behavioural and genetic determinants to further inform policy and practice.