Browsing by Author "Herath, K.K.W.H.P."

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Gestational diabetes mellitus and risk of type 2 diabetes 10 years after the index pregnancy in Sri Lankan women: a community based retrospective cohort study
(Sri Lanka Medical Association, 2017) Herath, K.K.W.H.P.; Herath, H.M.R.P.; Wickremasinghe, A.R.
INTRODUCTION & OBJECTIVES: Women with a history of gestational diabetes mellitus (GDM) have an increased risk of type 2 diabetes mellitus (T2DM) later in life. This study aimed to determine the risk of developing T2DM 10 years after GDM in Sri Lankan women. METHODS: A retrospective cohort study was conducted in the Colombo district. 7205 women who delivered a child in 2005 were identified through the PHM in the field. Women with antenatal records were interviewed and relevant data were extracted from medical records to identify potential participants. 119 women who had GDM and 240 women who did not have GDM were recruited. Current diagnosis of diabetes was based on the history and relevant medical records within the past 1 year. RESULTS: The mean duration of follow up was 10.9 (SD= 0.35) years in the GDM group and 10.8 (SD=0.31) years in the non-GDM group. The incidence density of diabetes in the GDM group was 56.3 per 1000 person years compared to 5.4 per 1000 person years in the non GDM group giving a rate ratio of 10.42 (95% CI 6.01-19.12). A woman with GDM was 10.6 times more likely to develop diabetes compared to women with no GDM after controlling for confounding variables. Delivering a child after 30 years, being treated with insulin during pregnancy and birth weight ≥ 3.5 Kg were significant predictors of development of T2DM. CONCLUSION: Women with GDM had a 10 fold higher risk of developing T2DM during a 10 year follow up period as compared to women with no GDM.
Hyperglycaemia in pregnancy and cardio metabolic risk parameters in the offspring at 10-11 years
(Sri Lanka Medical Association., 2019) Herath, K.K.W.H.P.; Herath, H.M.R.P.; Wickremasinghe, A.R.
INTRODUCTION & OBJECTIVES: Studies of developmental origins of health and disease have highlighted the possible role of hyperglycaemic intrauterine environment mediating and accelerating the current epidemic of diabetes and non-communicable diseases through foetal programming and epigenetic changes. While the perinatal and neonatal risks of hyperglycaemia in pregnancy (HIP) are well established, the long-term risks for the offspring are less explored. This study aimed to determine the association between HIP and cardiometabolic risk parameters in the offspring at 10-11 years. METHODS: A community based retrospective cohort study was conducted in the Colombo district. In the first stage, children born in 2005 were identified and the availability of antenatal records were assessed. In the second stage, exposure status of participants was ascertained based on antenatal records. In the third stage, eligible children were examined with blood pressure (BP), fasting blood sugar (FBS) and lipid profile to ascertain outcome status. RESULTS: 159 children of mothers with HIP (exposed) and 253 children of mothers with no HIP (non-exposed) participated. Mean ages (SD) of exposed and non-exposed groups were 10.9(0.3) and 10.8(0.3) years, respectively. Exposed children had a significantly higher risk of developing impaired fasting glycaemia (OR=5.6; 95% CI: 1.2-28.9), elevated total cholesterol (OR=2.1; 95% Cl: 1.3- 3.4), elevated low-density lipoprotein cholesterol (OR=1.9; 95% CI: 1.2-3.3) and elevated triglycerides (OR=2.5; 95% CI: 1.4-4.3). There was no significant difference in the BP and elevated high-density lipoprotein cholesterol between the exposed and non-exposed groups. CONCLUSION: Exposure to HIP increases the cardiometabolic risk in the offspring and these children need long-term follow up
Satisfaction with intrapartum and postpartum hospital care among mothers delivering at Colombo North Teaching Hospital
(Sri Lanka Medical Association, 2012) Herath, K.K.W.H.P.; Galappaththy, G.N.L.; Herath, H.M.R.P.
INTRODUCTION: Institutional intrapartum care with skilled attendance at delivery has greatly contributed to the reduction of maternal mortality in Sri Lanka. Users' evaluations are important for continuous quality monitoring and further improvement of maternal care services. AIMS: The aims were to describe satisfaction with intrapartum and postpartum hospital care, and to determine sociodemographic and pregnancy related factors associated with satisfaction. Methods: A cross sectional analytical study was conducted in Colombo North Teaching hospital (CNTH) Ragama involving 422 postnatal mothers with uncomplicated birth outcome. Data were collected using an exit interview. Patient satisfaction with intrapartum and postpartum care was assessed using two composite scales covering five satisfaction dimensions. Sociodemographic and pregnancy related factors associated with patient satisfaction were determined by odds ratio with 95% confidence interval. Results: The majority of mothers were "satisfied" with intrapartum (90.3%) and postpartum (91%) care. Interpersonal aspects of care was the most satisfied dimension. Mothers were least satisfied with physical environment. Factors significantly associated with satistaction with ftoth intrapartum and postpartum care were intended pregnancy, multiparity, having received field antenatal care and vaginal delivery. Age > 30 years, delivery > 40 weeks of POA and postpartum hospital stay 1 - 3 days were significantly associated with intrapartum care satisfaction. Residing within 10km of CNTH, immediate skin to skin contact and initiation of breastfeeding within 30 minutes were significantly associated with postpartum satisfaction. CONCLUSIONS: Factors associated with maternal satisfaction identified in this study should be used to deliver a more patient centered service and gain patient satisfaction.