Study of the prevalence of gestational diabetes among pregnant women visiting Al-Zahrawi Hospital and its risk factors

Study of the prevalence of gestational diabetes among pregnant women visiting Al-Zahrawi Hospital and its risk factors | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Study of the prevalence of gestational diabetes among pregnant women visiting Al-Zahrawi Hospital and its risk factors Hadeel Nizar Al-Omayan, Taghrid Hammoud This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4714238/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Gestational diabetes mellitus is the most common endocrine disorder that occurs during pregnancy, and its prevalence is increasing in all parts of the world. As a result of the impact of diabetes on both the mother and the fetus, it is a topic worthy of study. Research objective and its justification : To determine the prevalence of diabetes during pregnancy to confirm the use of screening tests in detecting diabetes during pregnancy. Research materials and methods: The study included 760 pregnant women who visited Al-Zahrawi Hospital during the period from June 2023 to December 2024, where information was recorded from the patients’ files and information related to the age of the pregnant woman, gestational age, and mass index, in addition to the tests necessary to diagnose diabetes during pregnancy, 73 pregnant women met positive criteria for the diagnosis of diabetes. Results : The rate of diabetes during pregnancy was 9.60% of all pregnant women. The highest percentage of diabetic pregnant women falls within the age group >30 years, and this percentage is 68.49% (p<0.001) The majority of diabetic pregnant women are in the third trimester of pregnancy, accounting for 71.23% of all diabetic pregnant women (p<0.001). Most diabetic pregnant women were overweight and obese, and the percentages reached 39.72% and 49.32%, respectively (p<0.001). Conclusion : The results of the study showed an increase in the rate of diabetes during pregnancy and therefore the importance of conducting screening tests. It emphasized that the advanced age of the pregnant woman, gestational age, and the presence of obesity in pregnant women are among the most important risk factors for diabetes during pregnancy. Endocrinology & Metabolism gestational diabetes obesity maternal age gestational age Introduction Pregnancy is one of the factors causing the development of cellular resistance to insulin, as it is primarily mediated by the placenta’s secretion of hormones that cause diabetes, including (growth hormone, corticotropin-releasing hormone, and human placental lactase stimulator (HPL). These metabolic changes are more evident in the third trimester of pregnancy. Because of the fetus’s need for nutrients [ 1 ] Gestational diabetes mellitus (GDM) develops in pregnant women whose pancreatic function is insufficient to overcome pregnancy-related insulin resistance. One of the main consequences of GDM is an increased risk of preeclampsia, which is a risk factor for preterm birth, cesarean section, and associated diseases. Patients with GDM are at high risk of developing type 2 diabetes in the future, because the pathophysiological pathway of insufficient insulin secretion in the state of insulin resistance during pregnancy is also the cause of type 2 diabetes outside of pregnancy [ 2 ]. GDM is associated with short- and long-term complications for both the mother and the fetus, as it causes some disorders during pregnancy, including premature labor, high blood pressure, fetal megaloblasty, intrauterine growth retardation, low levels of glucose and calcium in the blood, hyperbilirubinemia, erythema, In addition to perinatal deaths [ 2 – 3 ] Methods and materials Research importance: The prevalence of diabetes during pregnancy in the 1990s was 1.9% [ 2 ] and now it is 7% [ [ 3 ] [4], and this is due to two main reasons: the first is pregnancy at advanced ages, which is due to the late age of marriage; The second reason is the increase in the percentage of type 2 diabetes, as its percentage was 4.9% in 1990 and currently exceeds 7% of the total population [5] [6]. This is due to lifestyle, as we notice an increase in average weight among women, as the percentage has increased. Obesity in women according to body mass index has increased fourfold over the past two decades and this percentage has become about 34% [7] [8]. Therefore, the increase in the rate of type diabetes at the present time, and the increasing age of pregnant women, has increased the rate of pregnancies mixed with diabetes. Research objective: The research aims to determine the prevalence of gestational diabetes in pregnant women at Al-Zahrawi Hospital and to determine the factors that predispose it to its occurrence. Justifications for the research: This study is the first of its kind in Al-Zahrawi Hospital, and given the increasing incidence of diabetes in general, the late age of pregnancy, and the importance of detecting this in the prevention of maternal complications, which constitutes the basic justification for investigating the presence of this disease and early detection of it. Duration of study: one and a half years from 12/1/2023 to 5/15/2024. Place of study: Al-Zahrawi Hospital, specialized in obstetrics and gynecology, in Damascus, Syria. Study sample: Pregnant women attending Al-Zahrawi Hospital, which specializes in obstetrics and gynecology in Damascus, Syria. Sample size: The study included 760 pregnant women at various periods of pregnancy. Study method: The required data was collected and recorded for each pregnant woman included in the study. The pregnant woman's age, gestational age, height, and weight were recorded, and the mass index was calculated. The presence of diabetes in pregnant women was investigated according to the following: A woman who visits with diagnosed and treated diabetes will have her glucose hemoglobin titrated to control her diabetes. A woman who does not know and whose gestational age is less than 24 weeks undergoes a random calibration of her blood glucose value. The woman who did not know and my gestational age was more than 24 weeks had a fasting blood glucose titration and two hours after the OGTT. Diagnostic values ​​were determined according to the 2013 World Health Organization and American Diabetes Association guidelines. Data analysis: The statistical analysis was compared between two groups of pregnant women: diabetics and non-diabetics. The pregnant women were divided according to age into three age groups: 20 years, 20–30 years, and 30 years. According to the gestational age, pregnant women were divided into three categories: less than 13 weeks, 13–28 weeks, and more than 28 weeks. According to the mass index, pregnant women were divided into three categories: 24.92 kg/m2, 29.925 kg/m2, and 305 kg/m2. The prevalence of gestational diabetes in pregnant women was calculated, as well as the prevalence of diabetes within each category of the variables studied: the age of the pregnant woman, the gestational age, and the mass index. Statistical analysis: Tests that were used: The T-STUDENT test and the Chi Square test were used to analyze the data and to study the relationship of continuous variables (pregnant age, gestational age, mass index) and the incidence of diabetes during pregnancy. The Odds Ratio (OR) was calculated to investigate the risk factors: age of the pregnant woman, gestational age, and mass index for the occurrence of diabetes during pregnancy. The relative risk (RR) was calculated to determine the degree of risk for the occurrence of diabetes during pregnancy according to the variables of age, gestational age, and mass index. Confidence intervals (CI) at 95% intervals were calculated for both odds ratio and relative risk. The data were analyzed and the significance of statistical differences was estimated using the program 26 statistical package for social sciences SPSS v Differences were considered statistically significant when the P-Value was less than or equal to 0.05 (Level of Significance). Results The study was conducted on the files of pregnant women attending Al-Zahrawi Hospital, which specializes in obstetrics and gynecology in Damascus, Syria. The study included 760 pregnant women at various periods of pregnancy, and the pregnant women were classified into categories according to age, gestational age, and mass index. The percentage of pregnant women aged 30 years was 45.40%. The percentage of pregnant women with a gestational age of < 13 weeks was 19.6% (n = 149), the percentage of pregnant women with a gestational age of 13–28 weeks was 30.66 (n = 233), and the percentage of pregnant women with a gestational age of ≥ 28 weeks was 49.47% (n = 378). The percentage of pregnant women who had a BMI ≤ was 24.9%, 31.84% (n = 242), the percentage of pregnant women who had a BMI was 25-29.9%, 56.06% (n = 426), and the percentage of pregnant women who had a BMI ≥ 30%, 12.11% (n = 92). The number of births for patients ranged between zero (no previous births) and 14 births, with a mean value of 4.49 and a median value of 4. The number of pregnancies for patients ranged between 1 and 14 births, with a mean value of 4.49 and a median value of 4. Tests were conducted for pregnant women according to what was specified in the research methodology and the values ​​set by the World Health Organization for the diagnosis of gestational diabetes and the World Society of Endocrinology were adopted. The results were as follows: The percentage of presence of gestational diabetes was 9.6% (n = 73), while the remaining percentage amounted to 90.40. % represents the percentage of pregnant women who do not have gestational diabetes. The percentage of pregnant women who had gestational diabetes and were < 20 years old was 2.74% (n = 2), the percentage of pregnant women who had gestational diabetes and were 20–30 years old was 28.77% (n = 21), and the percentage of pregnant women who had gestational diabetes and were > 30 years 68.49% (n = 50). The proportion of pregnant women who had gestational diabetes and a gestational age of < 13 weeks was 4.11% (n = 3), the proportion of pregnant women who had gestational diabetes and a gestational age of 13–28 weeks (n = 18), the proportion of pregnant women who had gestational diabetes and a gestational age of Pregnancy ≥ 28 weeks 71.23% (n = 52). The percentage of pregnant women who had gestational diabetes and had a BMI of ≤ 24.9% was 10.96% (n = 8), and the percentage of pregnant women who had gestational diabetes and had a BMI of 25-29.9% was 39.72% (n = 29), while the percentage of Pregnant women with gestational diabetes and BMI ≥ 30%, 49.32% (n = 36). The prevalence of gestational diabetes in the age group 30 years 6.58% (n = 50) The prevalence of diabetes in women with a gestational age < 13 weeks was 0.39% (n = 3), and the prevalence of diabetes in women with a gestational age of 13–28 weeks was 2.37% (n = 18), while the prevalence of diabetes in women with a gestational age of 13–28 weeks was 2.37% (n = 18). Women with gestational age ≥ 28 weeks 6.84% (n = 52). The prevalence of diabetes in women with a BMI ≤ was 24.9%, 1.05% (n = 8), and the prevalence of diabetes in women with a BMI of 25 was 29.9%, 3.81% (n = 29), while the The prevalence of diabetes in women with a BMI ≥ 30% was 4.74% (n = 36). 39.13% of obese pregnant women were diagnosed with diabetes during pregnancy, while 6.81% of overweight pregnant women were diagnosed with diabetes, while 3.31% of pregnant women with normal body mass index were diagnosed with diabetes during pregnancy. The average age of non-diabetic pregnant women was 28.31 ± 7.48 years, while the average age of diabetic pregnant women was 33.40 ± 6.84 years. As for gestational age, the average gestational age of non-diabetic pregnant women was 25.28 ± 10.58 weeks of gestation, and that of diabetic pregnant women was 30.38 ± 7.08 weeks. As for the mass index, the average for non-sugars was 26.29 ± 2.83 kg/m2, while for sugars, the average mass index was 29.48 ± 3.44 kg/m2. The previous results show that there are differences between the two groups in age, gestational age, and body mass index. To find out whether these differences are statistically significant, we tested (T-STUDENT TEST), to study the differences between the two study groups with regard to age, gestational age, and body mass index, where We note that the p-value was < 0.001 for age, as well as for gestational age and body mass index, which is smaller than the significance level of 0.05, and therefore we accept the hypothesis that says: There are statistically significant differences between the two study groups (diabetic and non-diabetic pregnant women) with regard to the variables. Age, gestational age and body mass index. The variables were studied: the age of the pregnant woman, the gestational age, and the body mass index as a risk factor from a statistical standpoint, by finding the values ​​of the odds ratio (OR), the relative risk (RR), and the confidence interval (CI) for each of them, in order to determine the presence of a risk for diabetes according to the categories and the degree of risk, if any. The age variable was studied to investigate the presence of risk according to age groups and degree of risk, and the results were as follows: The value of OR > 1 and RR > 1 was achieved only in the age group over 30 years. This means that the age of the pregnant woman over 30 years constitutes a risk factor for diabetes during pregnancy, and this age group of pregnant women is 2.61 times more likely to develop gestational diabetes than In the rest of the age groups. As for the rest of the age groups, the OR and RR values ​​are less than 1, so these age groups are not considered risk factors. Noting that the relative risk RR reaches a higher value in the age group between 20–30 years. By examining the variable gestational age as a risk factor, the results were as follows: The value of OR > 1 and RR > 1 was achieved only in the group of gestational age greater than or equal to 28 weeks. This means that a gestational age equal to or greater than 28 weeks constitutes a risk factor for diabetes during pregnancy, and this group of pregnant women is 2.5 times more exposed. The incidence of gestational diabetes compared to other groups. By studying the body mass index variable, the results were as follows: The value of RR > 1 was achieved only in the category of BMI greater than or equal to 30 kg/m2. This means that a BMI equal to or greater than 30 kg/m2 constitutes a risk factor for diabetes during pregnancy and this category of pregnant women is 2.5 times more exposed. times the incidence of gestational diabetes compared to other groups. Discussion The study included 760 pregnant women from different periods of pregnancy, and the largest percentage of pregnant women were within the age group > 30 years, at a rate of 45.40% of the total number of pregnant women. Most of the pregnant women in the study sample were in the third trimester of pregnancy, and the percentage of this group was 49.74%, and most of the pregnant women were from Overweight women, as 56.05% of pregnant women have a body mass index between 25-29.9 kg/m2. The number of diabetic pregnant women reached 73, with a prevalence rate of 9.60%, and the highest percentage of diabetic pregnant women falls within the age group of 30 years, and this percentage reaches 68.49%, and the majority of diabetic pregnant women here are in the third trimester of pregnancy, with a rate of 71.23% of the total diabetic pregnant women. Most of the diabetic pregnant women were overweight and obese, and the percentages reached 39.72 and 49.32%, respectively. The highest prevalence of diabetes during pregnancy was in the age group > 30 years, at a rate of 6.58% of all pregnant women in the study. The highest prevalence of diabetes during pregnancy was in the third trimester of pregnancy, and the prevalence rate was 6.84%. The highest prevalence of diabetes during pregnancy was among pregnant women. Obese women, that is, those whose mass index was 30 kg/m or more, and the percentage was 4.74%. Diabetic pregnant women were older than non-diabetic pregnant women, as the average age of non-diabetic pregnant women was p-value < 0.001 (7.48 ± 28.31) years, while the average age of diabetic pregnant women was 33.40 ± 6.84 years. Diabetic pregnant women had an older gestational age than non-diabetic ones, as the average age was Gestational age for non-diabetic pregnant women was 25.28 ± 10.58 weeks and for diabetic women it was 30.38 ± 7.08 weeks p-value < 0.001 Diabetic pregnant women had a higher mass index than non-diabetic women. The average for non-diabetic women was 26.29 ± 2.83 kg/m2, while for diabetic women it was 29.48 + 3.44 kg/m2, p-value 30 years were diabetics. The age of the pregnant woman over 30 years constitutes a risk factor for diabetes during pregnancy, and this age group of pregnant women is 2.6 times more susceptible to the occurrence of gestational diabetes compared to the rest of the age groups (p-value < 0.001). Diabetes was diagnosed in 13.76% of pregnant women who entered the third trimester of pregnancy. A gestational age equal to or more than 28 weeks constitutes a risk factor for diabetes during pregnancy, and this group of pregnant women is 2.5 times more likely to develop gestational diabetes compared to the rest of the groups (p-value < 0.001). Declarations Ethical approval: The Research Ethics Committee at Syrian Private University and the ethical committees at the relevant Syrian Private University approved the study protocol. Verbal informed consent was obtained from the participant All procedures performed in studies involving the participant and human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards Consent for publication: Not applicable. Availability of data and materials: All data produced in the present work are contained in the manuscript Conflict of interest: The authors declare that they have no Conflict of interest: Funding: Unavailable Acknowledgments: We are thankful to the management of the Syrian Private University for their support in the eld of medical training and research. We would also like to thank Dr. Taghrid Hammoud for his help and supervision in the paper, we would like to thank the male and female students participating in the study. References Venkatesh KK, Lynch CD, Powe CE et al (2022) Risk of Adverse Pregnancy Outcomes Among Pregnant Individuals with Gestational Diabetes by Race and Ethnicity in the United States, 2014–2020. JAMA 327:1356 Black MH, Sacks DA, Xiang AH, Lawrence JM (2013) The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care 36:56 Hillier TA, Pedula KL, Vesco KK et al (2008) Excess gestational weight gain: modifying fetal macrosomia risk associated with maternal glucose. Obstet Gynecol 112:1007 Additional Declarations The authors declare potential competing interests as follows: All authors have read the manuscript and approved for publication Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4714238","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":324884214,"identity":"7783cd9e-1df4-48b5-9326-c543b1620660","order_by":0,"name":"Hadeel Nizar Al-Omayan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+klEQVRIiWNgGAWjYBACAzAqYOABstk/JFQAKWbmBiK0GIC1sDE8OAPSwkicFhBgY3zYBqIJaDFnP7zxwQeDOzLy7WefPUicVxvN3w7U8qNiG04tlj1pxYYzDJ7xMPakmxskbjueO+MwYwNjz5nbuB12IMdMmsfgMA8zQxqDROK2Y7kNQC3MjG14tJx/Y/77D1ALG/8zoJY5x3LnE9RyI8eMmQGohUcijU0isaEmdwNhLc+KJXuAWiQknjEbJBw7kLsRqOUgXr+cT9744UfFYXv5/jTGhz9q6nLnnT988MGPCtxa0MFhMHmAaPVAUEeK4lEwCkbBKBghAAAqO1vwgjF2RQAAAABJRU5ErkJggg==","orcid":"","institution":"Faculty of medicine, Syrian Private University, Damascus, Syria.","correspondingAuthor":true,"prefix":"","firstName":"Hadeel","middleName":"Nizar","lastName":"Al-Omayan","suffix":""},{"id":324884215,"identity":"5e46ed83-3d98-4a8b-9bf1-e3a3dfec2b80","order_by":1,"name":"Taghrid Hammoud","email":"","orcid":"","institution":"Department of Internal Medicine, Syrian Private University, Damascus, Syria.","correspondingAuthor":false,"prefix":"","firstName":"Taghrid","middleName":"","lastName":"Hammoud","suffix":""}],"badges":[],"createdAt":"2024-07-09 20:17:59","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4714238/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4714238/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60072171,"identity":"f3ce1924-56b4-420a-ac73-d466623600d0","added_by":"auto","created_at":"2024-07-11 11:25:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":258767,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4714238/v1/7b8f0ce6-d8c2-4048-87a6-d19032a27d35.pdf"}],"financialInterests":"The authors declare potential competing interests as follows: All authors have read the manuscript and approved for publication","formattedTitle":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eStudy of the prevalence of gestational diabetes among pregnant women visiting Al-Zahrawi Hospital and its risk factors\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePregnancy is one of the factors causing the development of cellular resistance to insulin, as it is primarily mediated by the placenta\u0026rsquo;s secretion of hormones that cause diabetes, including (growth hormone, corticotropin-releasing hormone, and human placental lactase stimulator (HPL). These metabolic changes are more evident in the third trimester of pregnancy. Because of the fetus\u0026rsquo;s need for nutrients [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eGestational diabetes mellitus (GDM) develops in pregnant women whose pancreatic function is insufficient to overcome pregnancy-related insulin resistance. One of the main consequences of GDM is an increased risk of preeclampsia, which is a risk factor for preterm birth, cesarean section, and associated diseases. Patients with GDM are at high risk of developing type 2 diabetes in the future, because the pathophysiological pathway of insufficient insulin secretion in the state of insulin resistance during pregnancy is also the cause of type 2 diabetes outside of pregnancy [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGDM is associated with short- and long-term complications for both the mother and the fetus, as it causes some disorders during pregnancy, including premature labor, high blood pressure, fetal megaloblasty, intrauterine growth retardation, low levels of glucose and calcium in the blood, hyperbilirubinemia, erythema, In addition to perinatal deaths [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e"},{"header":"Methods and materials","content":"\u003cp\u003eResearch importance:\u003c/p\u003e \u003cp\u003eThe prevalence of diabetes during pregnancy in the 1990s was 1.9% [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] and now it is 7% [ [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] [4], and this is due to two main reasons: the first is pregnancy at advanced ages, which is due to the late age of marriage; The second reason is the increase in the percentage of type 2 diabetes, as its percentage was 4.9% in 1990 and currently exceeds 7% of the total population [5] [6]. This is due to lifestyle, as we notice an increase in average weight among women, as the percentage has increased. Obesity in women according to body mass index has increased fourfold over the past two decades and this percentage has become about 34% [7] [8]. Therefore, the increase in the rate of type diabetes at the present time, and the increasing age of pregnant women, has increased the rate of pregnancies mixed with diabetes.\u003c/p\u003e \u003cp\u003eResearch objective: The research aims to determine the prevalence of gestational diabetes in pregnant women at Al-Zahrawi Hospital and to determine the factors that predispose it to its occurrence.\u003c/p\u003e \u003cp\u003eJustifications for the research: This study is the first of its kind in Al-Zahrawi Hospital, and given the increasing incidence of diabetes in general, the late age of pregnancy, and the importance of detecting this in the prevention of maternal complications, which constitutes the basic justification for investigating the presence of this disease and early detection of it.\u003c/p\u003e \u003cp\u003eDuration of study: one and a half years from 12/1/2023 to 5/15/2024.\u003c/p\u003e \u003cp\u003ePlace of study: Al-Zahrawi Hospital, specialized in obstetrics and gynecology, in Damascus, Syria.\u003c/p\u003e \u003cp\u003eStudy sample: Pregnant women attending Al-Zahrawi Hospital, which specializes in obstetrics and gynecology in Damascus, Syria. Sample size: The study included 760 pregnant women at various periods of pregnancy.\u003c/p\u003e \u003cp\u003eStudy method:\u003c/p\u003e \u003cp\u003eThe required data was collected and recorded for each pregnant woman included in the study.\u003c/p\u003e \u003cp\u003eThe pregnant woman's age, gestational age, height, and weight were recorded, and the mass index was calculated.\u003c/p\u003e \u003cp\u003eThe presence of diabetes in pregnant women was investigated according to the following:\u003c/p\u003e \u003cp\u003eA woman who visits with diagnosed and treated diabetes will have her glucose hemoglobin titrated to control her diabetes.\u003c/p\u003e \u003cp\u003eA woman who does not know and whose gestational age is less than 24 weeks undergoes a random calibration of her blood glucose value.\u003c/p\u003e \u003cp\u003eThe woman who did not know and my gestational age was more than 24 weeks had a fasting blood glucose titration and two hours after the OGTT.\u003c/p\u003e \u003cp\u003e Diagnostic values ​​were determined according to the 2013 World Health Organization and American Diabetes Association guidelines.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData analysis:\u003c/h2\u003e \u003cp\u003eThe statistical analysis was compared between two groups of pregnant women: diabetics and non-diabetics.\u003c/p\u003e \u003cp\u003eThe pregnant women were divided according to age into three age groups: 20 years, 20\u0026ndash;30 years, and 30 years.\u003c/p\u003e \u003cp\u003eAccording to the gestational age, pregnant women were divided into three categories: less than 13 weeks, 13\u0026ndash;28 weeks, and more than 28 weeks. According to the mass index, pregnant women were divided into three categories: 24.92 kg/m2, 29.925 kg/m2, and 305 kg/m2.\u003c/p\u003e \u003cp\u003eThe prevalence of gestational diabetes in pregnant women was calculated, as well as the prevalence of diabetes within each category of the variables studied: the age of the pregnant woman, the gestational age, and the mass index.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis:\u003c/h2\u003e \u003cp\u003eTests that were used:\u003c/p\u003e \u003cp\u003eThe T-STUDENT test and the Chi Square test were used to analyze the data and to study the relationship of continuous variables (pregnant age, gestational age, mass index) and the incidence of diabetes during pregnancy.\u003c/p\u003e \u003cp\u003eThe Odds Ratio (OR) was calculated to investigate the risk factors: age of the pregnant woman, gestational age, and mass index for the occurrence of diabetes during pregnancy.\u003c/p\u003e \u003cp\u003eThe relative risk (RR) was calculated to determine the degree of risk for the occurrence of diabetes during pregnancy according to the variables of age, gestational age, and mass index.\u003c/p\u003e \u003cp\u003eConfidence intervals (CI) at 95% intervals were calculated for both odds ratio and relative risk.\u003c/p\u003e \u003cp\u003eThe data were analyzed and the significance of statistical differences was estimated using the program 26 statistical package for social sciences SPSS v\u003c/p\u003e \u003cp\u003eDifferences were considered statistically significant when the P-Value was less than or equal to 0.05 (Level of Significance).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe study was conducted on the files of pregnant women attending Al-Zahrawi Hospital, which specializes in obstetrics and gynecology in Damascus, Syria. The study included 760 pregnant women at various periods of pregnancy, and the pregnant women were classified into categories according to age, gestational age, and mass index.\u003c/p\u003e \u003cp\u003eThe percentage of pregnant women aged\u0026thinsp;\u0026lt;\u0026thinsp;20 years was 17.36% (n\u0026thinsp;=\u0026thinsp;132), the percentage of pregnant women aged 20\u0026ndash;30 years was 37.24% (n\u0026thinsp;=\u0026thinsp;283), and the percentage of pregnant women aged\u0026thinsp;\u0026gt;\u0026thinsp;30 years was 45.40%.\u003c/p\u003e \u003cp\u003eThe percentage of pregnant women with a gestational age of \u0026lt;\u0026thinsp;13 weeks was 19.6% (n\u0026thinsp;=\u0026thinsp;149), the percentage of pregnant women with a gestational age of 13\u0026ndash;28 weeks was 30.66 (n\u0026thinsp;=\u0026thinsp;233), and the percentage of pregnant women with a gestational age of \u0026ge;\u0026thinsp;28 weeks was 49.47% (n\u0026thinsp;=\u0026thinsp;378).\u003c/p\u003e \u003cp\u003eThe percentage of pregnant women who had a BMI\u0026thinsp;\u0026le;\u0026thinsp;was 24.9%, 31.84% (n\u0026thinsp;=\u0026thinsp;242), the percentage of pregnant women who had a BMI was 25-29.9%, 56.06% (n\u0026thinsp;=\u0026thinsp;426), and the percentage of pregnant women who had a BMI\u0026thinsp;\u0026ge;\u0026thinsp;30%, 12.11% (n\u0026thinsp;=\u0026thinsp;92).\u003c/p\u003e \u003cp\u003eThe number of births for patients ranged between zero (no previous births) and 14 births, with a mean value of 4.49 and a median value of 4. The number of pregnancies for patients ranged between 1 and 14 births, with a mean value of 4.49 and a median value of 4.\u003c/p\u003e \u003cp\u003eTests were conducted for pregnant women according to what was specified in the research methodology and the values ​​set by the World Health Organization for the diagnosis of gestational diabetes and the World Society of Endocrinology were adopted. The results were as follows: The percentage of presence of gestational diabetes was 9.6% (n\u0026thinsp;=\u0026thinsp;73), while the remaining percentage amounted to 90.40. % represents the percentage of pregnant women who do not have gestational diabetes.\u003c/p\u003e \u003cp\u003eThe percentage of pregnant women who had gestational diabetes and were \u0026lt;\u0026thinsp;20 years old was 2.74% (n\u0026thinsp;=\u0026thinsp;2), the percentage of pregnant women who had gestational diabetes and were 20\u0026ndash;30 years old was 28.77% (n\u0026thinsp;=\u0026thinsp;21), and the percentage of pregnant women who had gestational diabetes and were \u0026gt;\u0026thinsp;30 years 68.49% (n\u0026thinsp;=\u0026thinsp;50).\u003c/p\u003e \u003cp\u003eThe proportion of pregnant women who had gestational diabetes and a gestational age of \u0026lt;\u0026thinsp;13 weeks was 4.11% (n\u0026thinsp;=\u0026thinsp;3), the proportion of pregnant women who had gestational diabetes and a gestational age of 13\u0026ndash;28 weeks (n\u0026thinsp;=\u0026thinsp;18), the proportion of pregnant women who had gestational diabetes and a gestational age of Pregnancy\u0026thinsp;\u0026ge;\u0026thinsp;28 weeks 71.23% (n\u0026thinsp;=\u0026thinsp;52).\u003c/p\u003e \u003cp\u003eThe percentage of pregnant women who had gestational diabetes and had a BMI of \u0026le;\u0026thinsp;24.9% was 10.96% (n\u0026thinsp;=\u0026thinsp;8), and the percentage of pregnant women who had gestational diabetes and had a BMI of 25-29.9% was 39.72% (n\u0026thinsp;=\u0026thinsp;29), while the percentage of Pregnant women with gestational diabetes and BMI\u0026thinsp;\u0026ge;\u0026thinsp;30%, 49.32% (n\u0026thinsp;=\u0026thinsp;36).\u003c/p\u003e \u003cp\u003eThe prevalence of gestational diabetes in the age group\u0026thinsp;\u0026lt;\u0026thinsp;20 years was 0.26% (n\u0026thinsp;=\u0026thinsp;2), the prevalence of gestational diabetes in the age group 20\u0026ndash;30 years was 2.76% (n\u0026thinsp;=\u0026thinsp;21), and the prevalence of gestational diabetes in the age group\u0026thinsp;\u0026gt;\u0026thinsp;30 years 6.58% (n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003cp\u003eThe prevalence of diabetes in women with a gestational age\u0026thinsp;\u0026lt;\u0026thinsp;13 weeks was 0.39% (n\u0026thinsp;=\u0026thinsp;3), and the prevalence of diabetes in women with a gestational age of 13\u0026ndash;28 weeks was 2.37% (n\u0026thinsp;=\u0026thinsp;18), while the prevalence of diabetes in women with a gestational age of 13\u0026ndash;28 weeks was 2.37% (n\u0026thinsp;=\u0026thinsp;18). Women with gestational age\u0026thinsp;\u0026ge;\u0026thinsp;28 weeks 6.84% (n\u0026thinsp;=\u0026thinsp;52).\u003c/p\u003e \u003cp\u003eThe prevalence of diabetes in women with a BMI\u0026thinsp;\u0026le;\u0026thinsp;was 24.9%, 1.05% (n\u0026thinsp;=\u0026thinsp;8), and the prevalence of diabetes in women with a BMI of 25 was 29.9%, 3.81% (n\u0026thinsp;=\u0026thinsp;29), while the The prevalence of diabetes in women with a BMI\u0026thinsp;\u0026ge;\u0026thinsp;30% was 4.74% (n\u0026thinsp;=\u0026thinsp;36).\u003c/p\u003e \u003cp\u003e39.13% of obese pregnant women were diagnosed with diabetes during pregnancy, while 6.81% of overweight pregnant women were diagnosed with diabetes, while 3.31% of pregnant women with normal body mass index were diagnosed with diabetes during pregnancy.\u003c/p\u003e \u003cp\u003eThe average age of non-diabetic pregnant women was 28.31\u0026thinsp;\u0026plusmn;\u0026thinsp;7.48 years, while the average age of diabetic pregnant women was 33.40\u0026thinsp;\u0026plusmn;\u0026thinsp;6.84 years. As for gestational age, the average gestational age of non-diabetic pregnant women was 25.28\u0026thinsp;\u0026plusmn;\u0026thinsp;10.58 weeks of gestation, and that of diabetic pregnant women was 30.38\u0026thinsp;\u0026plusmn;\u0026thinsp;7.08 weeks. As for the mass index, the average for non-sugars was 26.29\u0026thinsp;\u0026plusmn;\u0026thinsp;2.83 kg/m2, while for sugars, the average mass index was 29.48\u0026thinsp;\u0026plusmn;\u0026thinsp;3.44 kg/m2.\u003c/p\u003e \u003cp\u003eThe previous results show that there are differences between the two groups in age, gestational age, and body mass index. To find out whether these differences are statistically significant, we tested (T-STUDENT TEST), to study the differences between the two study groups with regard to age, gestational age, and body mass index, where We note that the p-value was \u0026lt;\u0026thinsp;0.001 for age, as well as for gestational age and body mass index, which is smaller than the significance level of 0.05, and therefore we accept the hypothesis that says: There are statistically significant differences between the two study groups (diabetic and non-diabetic pregnant women) with regard to the variables. Age, gestational age and body mass index.\u003c/p\u003e \u003cp\u003eThe variables were studied: the age of the pregnant woman, the gestational age, and the body mass index as a risk factor from a statistical standpoint, by finding the values ​​of the odds ratio (OR), the relative risk (RR), and the confidence interval (CI) for each of them, in order to determine the presence of a risk for diabetes according to the categories and the degree of risk, if any.\u003c/p\u003e \u003cp\u003eThe age variable was studied to investigate the presence of risk according to age groups and degree of risk, and the results were as follows:\u003c/p\u003e \u003cp\u003eThe value of OR\u0026thinsp;\u0026gt;\u0026thinsp;1 and RR\u0026thinsp;\u0026gt;\u0026thinsp;1 was achieved only in the age group over 30 years. This means that the age of the pregnant woman over 30 years constitutes a risk factor for diabetes during pregnancy, and this age group of pregnant women is 2.61 times more likely to develop gestational diabetes than In the rest of the age groups.\u003c/p\u003e \u003cp\u003eAs for the rest of the age groups, the OR and RR values ​​are less than 1, so these age groups are not considered risk factors. Noting that the relative risk RR reaches a higher value in the age group between 20\u0026ndash;30 years.\u003c/p\u003e \u003cp\u003eBy examining the variable gestational age as a risk factor, the results were as follows:\u003c/p\u003e \u003cp\u003eThe value of OR\u0026thinsp;\u0026gt;\u0026thinsp;1 and RR\u0026thinsp;\u0026gt;\u0026thinsp;1 was achieved only in the group of gestational age greater than or equal to 28 weeks. This means that a gestational age equal to or greater than 28 weeks constitutes a risk factor for diabetes during pregnancy, and this group of pregnant women is 2.5 times more exposed. The incidence of gestational diabetes compared to other groups.\u003c/p\u003e \u003cp\u003eBy studying the body mass index variable, the results were as follows:\u003c/p\u003e \u003cp\u003eThe value of RR\u0026thinsp;\u0026gt;\u0026thinsp;1 was achieved only in the category of BMI greater than or equal to 30 kg/m2. This means that a BMI equal to or greater than 30 kg/m2 constitutes a risk factor for diabetes during pregnancy and this category of pregnant women is 2.5 times more exposed. times the incidence of gestational diabetes compared to other groups.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study included 760 pregnant women from different periods of pregnancy, and the largest percentage of pregnant women were within the age group\u0026thinsp;\u0026gt;\u0026thinsp;30 years, at a rate of 45.40% of the total number of pregnant women. Most of the pregnant women in the study sample were in the third trimester of pregnancy, and the percentage of this group was 49.74%, and most of the pregnant women were from Overweight women, as 56.05% of pregnant women have a body mass index between 25-29.9 kg/m2.\u003c/p\u003e \u003cp\u003eThe number of diabetic pregnant women reached 73, with a prevalence rate of 9.60%, and the highest percentage of diabetic pregnant women falls within the age group of 30 years, and this percentage reaches 68.49%, and the majority of diabetic pregnant women here are in the third trimester of pregnancy, with a rate of 71.23% of the total diabetic pregnant women. Most of the diabetic pregnant women were overweight and obese, and the percentages reached 39.72 and 49.32%, respectively.\u003c/p\u003e \u003cp\u003eThe highest prevalence of diabetes during pregnancy was in the age group\u0026thinsp;\u0026gt;\u0026thinsp;30 years, at a rate of 6.58% of all pregnant women in the study. The highest prevalence of diabetes during pregnancy was in the third trimester of pregnancy, and the prevalence rate was 6.84%. The highest prevalence of diabetes during pregnancy was among pregnant women. Obese women, that is, those whose mass index was 30 kg/m or more, and the percentage was 4.74%.\u003c/p\u003e \u003cp\u003eDiabetic pregnant women were older than non-diabetic pregnant women, as the average age of non-diabetic pregnant women was p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001 (7.48\u0026thinsp;\u0026plusmn;\u0026thinsp;28.31) years, while the average age of diabetic pregnant women was 33.40\u0026thinsp;\u0026plusmn;\u0026thinsp;6.84 years. Diabetic pregnant women had an older gestational age than non-diabetic ones, as the average age was Gestational age for non-diabetic pregnant women was 25.28\u0026thinsp;\u0026plusmn;\u0026thinsp;10.58 weeks and for diabetic women it was 30.38\u0026thinsp;\u0026plusmn;\u0026thinsp;7.08 weeks p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003eDiabetic pregnant women had a higher mass index than non-diabetic women. The average for non-diabetic women was 26.29\u0026thinsp;\u0026plusmn;\u0026thinsp;2.83 kg/m2, while for diabetic women it was 29.48\u0026thinsp;+\u0026thinsp;3.44 kg/m2, p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/p\u003e \u003cp\u003e14.49% of pregnant women aged\u0026thinsp;\u0026gt;\u0026thinsp;30 years were diabetics. The age of the pregnant woman over 30 years constitutes a risk factor for diabetes during pregnancy, and this age group of pregnant women is 2.6 times more susceptible to the occurrence of gestational diabetes compared to the rest of the age groups (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eDiabetes was diagnosed in 13.76% of pregnant women who entered the third trimester of pregnancy. A gestational age equal to or more than 28 weeks constitutes a risk factor for diabetes during pregnancy, and this group of pregnant women is 2.5 times more likely to develop gestational diabetes compared to the rest of the groups (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Research Ethics Committee at Syrian Private University and the ethical committees at the relevant Syrian Private University approved the study protocol. Verbal informed consent was obtained from the participant All procedures performed in studies involving the participant and human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data produced in the present work are contained in the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no Conflict of interest:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnavailable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are thankful to the management of the Syrian Private University for their support in the eld of medical training and research. We would also like to thank Dr. Taghrid Hammoud for his help and supervision in the paper, we would like to thank the male and female students participating in the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eVenkatesh KK, Lynch CD, Powe CE et al (2022) Risk of Adverse Pregnancy Outcomes Among Pregnant Individuals with Gestational Diabetes by Race and Ethnicity in the United States, 2014\u0026ndash;2020. JAMA 327:1356\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBlack MH, Sacks DA, Xiang AH, Lawrence JM (2013) The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care 36:56\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHillier TA, Pedula KL, Vesco KK et al (2008) Excess gestational weight gain: modifying fetal macrosomia risk associated with maternal glucose. Obstet Gynecol 112:1007\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[{"identity":"1b1ec1b9-a59d-4955-91cb-12b110fafe77","identifier":"10.13039/100016418","name":"B.K. Kee Foundation","awardNumber":"0996066591","order_by":0}],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Syrian Private University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"gestational diabetes, obesity, maternal age, gestational age","lastPublishedDoi":"10.21203/rs.3.rs-4714238/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4714238/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Gestational diabetes mellitus is the most common endocrine disorder that occurs during pregnancy, and its prevalence is increasing in all parts of the world. As a result of the impact of diabetes on both the mother and the fetus, it is a topic worthy of study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch objective and its justification\u003c/strong\u003e: To determine the prevalence of diabetes during pregnancy to confirm the use of screening tests in detecting diabetes during pregnancy.\u003c/p\u003e\n\u003cp\u003eResearch materials and methods: The study included 760 pregnant women who visited Al-Zahrawi Hospital during the period from June 2023 to December 2024, where information was recorded from the patients’ files and information related to the age of the pregnant woman, gestational age, and mass index, in addition to the tests necessary to diagnose diabetes during pregnancy, 73 pregnant women met positive criteria for the diagnosis of diabetes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The rate of diabetes during pregnancy was 9.60% of all pregnant women. The highest percentage of diabetic pregnant women falls within the age group \u0026gt;30 years, and this percentage is 68.49% (p\u0026lt;0.001)\u003c/p\u003e\n\u003cp\u003eThe majority of diabetic pregnant women are in the third trimester of pregnancy, accounting for 71.23% of all diabetic pregnant women (p\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003eMost diabetic pregnant women were overweight and obese, and the percentages reached 39.72% and 49.32%, respectively (p\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The results of the study showed an increase in the rate of diabetes during pregnancy and therefore the importance of conducting screening tests. It emphasized that the advanced age of the pregnant woman, gestational age, and the presence of obesity in pregnant women are among the most important risk factors for diabetes during pregnancy.\u003c/p\u003e","manuscriptTitle":"Study of the prevalence of gestational diabetes among pregnant women visiting Al-Zahrawi Hospital and its risk factors","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-11 11:16:56","doi":"10.21203/rs.3.rs-4714238/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e2f4a489-d4ef-4e2c-a468-8644ad042d03","owner":[],"postedDate":"July 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":34365522,"name":"Endocrinology \u0026 Metabolism"}],"tags":[],"updatedAt":"2024-07-11T11:16:56+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-11 11:16:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4714238","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4714238","identity":"rs-4714238","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}