Prevalence of Gestational Diabetes Mellitus and Maternal and Fetal Outcomes at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria
Journal of Advances in Medicine and Medical Research,
Page 1-16
DOI:
10.9734/jammr/2019/v31i930319
Abstract
Background: Gestational diabetes mellitus (GDM) is a common cause of hyperglycaemia in pregnancy accounting for about 90% of all diabetic pregnancies. Women with GDM are at increased risk of maternal and fetal morbidity and mortality which are preventable through early diagnosis and treatment.
Objective: The aim was to determine the prevalence of GDM, compare the maternal and neonatal complications among GDM and non-GDM pregnant women, and the risk factors associated with GDM.
Methodology: A prospective cohort study was carried out among 105 pregnant women attending the antenatal clinic of RSUTH between February and August 2017. They were interviewed using a pre-structured questionnaire that covered variables related to socio-demographic factors and family, medical, and social history. Fasting blood sugar (FBS) was done after an overnight fast. Women who had FBS less than 7 mmol/L had 75 g Oral Glucose Tolerant Test (OGTT) done. Those diagnosed with gestational diabetes mellitus were the exposed group while those negative for GDM were the non-exposed group. Both groups were followed up to delivery, and maternal and fetal outcomes were noted. Statistical analysis was carried out using SPSS version 20 and significance set at p < 0.05.
Results: The prevalence of GDM was 10.5%. Positive history of GDM in previous pregnancy was the only independent risk factor (p=0.04, Adj OR: 26.89, 95% CI 2.86 to 252.61). GDM mothers had a significantly higher risk of developing pre-eclampsia (RR=7.48; 95% CI =3.36 to 16.63). Neonates of GDM mothers were at increased risk of fetal macrosomia (RR =9.00; 95% CI=1.36 to 59.4) and neonatal admissions (RR=8.00; C.I =1.19 to 53.67).
Conclusion: The study revealed that the prevalence of GDM was high and that those with GDM were at increased risk of developing fetal and maternal complications. A history of GDM in previous pregnancy was an essential risk factor for subsequent GDM.
Keywords:
- Gestational diabetes mellitus
- prevalence
- risk factors
- maternal and fetal outcome
How to Cite
References
Gilmartin A, Ural SH, Repke JT. Gestational diabetes mellitus. Reviews inObstetrics and Gynaecology. 2008;1(3): 129-134.
Ugege WE, Abasiatta A, Umoiyoho A, Utuk M. The prevalence of gestational diabetes among antenatal attendees in a tertiary hospital in South-South Nigeria. International Journal of Medical and Health Research. 2015;1(1):72-79.
Wokoma FS, John CT, Enyindah CE. Gestational diabetes mellitus in a Nigerian antenatal population. Trop J Obstet Gynaecol. 2001;18(2):56-60.
Ewenighi CO, Nwanjo HU, Dimkpa U, Onyeanusi JC, Nnatuanya IN, Onoh L M, et al. Risk Factors Among pregnant women in Abakaliki metropolis, Ebonyi State Nigeria. NJIRM. 2013;4(1):56-61.
Akinjinmi AA, Adeyooye OA, Akingbade OA, Okerentugba PO. Prevalence of diabetes mellitus in Abeokuta Ogun state Nigeria. Researcher. 2014;6(2):73-7. Available:http://www.sciencepub.net/researcher
[Accessed 14 October 2019]
David CS, Robert WL. Diagnosis and management of gestational diabetes mellitus. Am Fam Physician. 2009;80(1): 57-62.
Available:http://www.aafp.org/afp
[Accessed 30 September 2019]
Assiamira F. Increasing prevalence of gestational diabetes mellitus: A public health perspective. Diabetes Care. 2007; 30(2):141-146.
Available:care.diabetesjournals.org
[Accessed 2 October 2019]
Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S et al. Prevalence of gestational diabetes mellitus and risk factors in Chinese pregnant women: A prospective population based study in Tianjin, China. PLoS ONE. 2015;10(3): 1371-1378.
Gestational diabetes.
htt://en.wikipedia/wiki/gestational diabetes
[accessed 14July 2019]
Ana MR, Natali PF, Fernandez MD, Laura DV, Elena B, Ana R et al. Risk factors for gestational diabetes mellitus in a large population of women living in Spain: Implications of preventive strategies. International Journal of Endocrinology. 2012;2012(2012):1155-1164.
Khan R, Ali K, Khan Z. Socio-demographic risk factors of gestational diabetes mellitus. Pakistan Journal of Medical Sciences. 2013;29(3):843-846.
Odar E, Wandabwa J, Kiondo P. Maternal and fetal outcome of gestational diabetes mellitus Mulago Hospital, Uganda. African Health Science. 2004;4(1):9-14.
Wahi P, Dogra V, Jandial K, Bhagat R, Gupta R, Gupta S, et al. Prevalence of gestational diabetes mellitus (GDM) and its outcomes Jammu Region. Journal of Association of Physician India. 2011;59: 227-229.
Dim CC, Okafor C, Ikenna AC, Anyahie BU. Diabetes mellitus in pregnancy: An update on the current classification and management. Nigerian Journal of Medicine. 2012;21(4):371-376.
Ugboma HAA, Abinoma H, Ukaigwe P. Gestational diabetes: Risk factors, perinatal complications and screening importance in Niger Delta region of Nigeria: A public health dilemma. International Journal of Tropical Disease and Health. 2012;2(1): 42-54.
Mwanri AW, Kinabo J, Ramaiya K, Feskens EJM. Gestational diabetes mellitus in sub-Saharan Africa: Systematic review and meta regression on prevalence and risk factors. Tropical Medicine and International Health. 2015;20(8):985-1002.
Anzaku AS, Musa J. Prevalence and associated risk factors for gestational diabetes in Jos, North-Central Nigeria. Archives of Gynecology and Obstetrics. 2013;287(5):859-863.
Kuti MA, Abbiyesuku FM, Akinade KS, Akinosun OM, Adeleye JO et al. Oral glucose tolerance testing outcomes among women at high risk for gestational diabetes mellitus. J Clin Pathol. 2011; 64(8):718-721.
Akhidue K, Unachukwu C, Chinenye S. Diabetes in pregnancy: The Nigerian perspective using the New WHO criteria. Journal of LMDA. 2017;17(1):60-64.
Getahun D, Nath C, Ananth C, Chaves M, Simulian J. Gestational diabetes in theUnited States: Temporal trends 1989 through 2004. Am J Obstet Gynaecol. 2008;198(1):525.
Ehrlich S, Hedderson M, Feng J, Davenport E, Gunderson E, Ferrara A. Change in body mass index between pregnancies and risks of gestational diabetes in a second pregnancy. Am J Obstet Gynaecol. 2011;117:1323- 1330.
Lin TC, Mu CF, Hsu CY. Risk factors for gestational diabetes: Ethnic disparities. Aust J Rural Health. 2015;23(3):176- 180.
Ali AD, Mehrass AO, Al-Adhroey AH, Al-Shammakh A, Amran A. Prevalence and risk factors of gestational diabetes mellitus in Yemen. International Journal of Women's Health. 2016;2016(8):35-41.
Niyibizi JB, Safari F, Ahishakiye B, Habimana JB, Herbert Mapira H, Mutuku NC. Gestational Diabetes Mellitus and Its Associated Risk Factors in Pregnant Women at Selected Health Facilities in Kigali City, Rwanda. Journal of Diabetes Medicine. 2016;6(4):269- 276.
Bener A, Saleh NM, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: Global comparisons. Int J Women’s Health. 2011;3:367-373.
Kew S, Ye C, Sermer M. Postpartum metabolic function in women delivering a macrosomic infant in the absence of gestational diabetes mellitus. Diabetes Care. 2011;34(12):2608- 2613.
Erem C, Kuzu UB, Deger O, Can G. Prevalence of gestational diabetes mellitus and associated risk factors in Turkish women: The Trabzon GDM Study. Arch Med Sci. 2015;11(4):724- 735.
John CO, Alegbeleye JO, Otoide AO. Feto-maternal outcome of diabetes in a tertiary health facility in Nigeria. African Journal of Diabetes Medicine. 2015;23(2): 1-4.
Varghese R, Thomas B, Moza Al, Hail MA, Rauf A, Al Sadi M, Al Sualiti. The Prevalence, Risk Factors, Maternal and Fetal outcomes in Gestational Diabetes Mellitus. Int. J. of Drug Dev and Res. 2012;4(3):356-368.
Sreelakshmi R, Nair S, Soman B, Alex R, Vijayakumar K, Kutty V. Maternal and neonatal outcomes of gestational diabetes: A retrospective cohort study from Southern India. J Family Med Prim Care. 2015;4(3):395-398.
Augusto AR, Silva JC, Ferreira B, Silva MR, Bertini AM. Impact of gestational diabetes on neonatal outcomes: A retrospective cohort study. Scientia Medica. 2015;25(1).
Rashid FB, Khatoon H, Hasnat MA, Amin R, Azad AK. Perinatal Complications in Diabetes Mellitus with Pregnancy: Comparison between Gestational Diabetes Mellitus (GDM) and Diabetes Mellitus Prior to Pregnancy. Mymensingh Med J. 2017;26(1):124-130.
Deryabina EG, Yakornova GV, Pestryaeva LA, Sandyreva D. Perinatal outcome in pregnancies complicated with gestational diabetes mellitus and very preterm birth: Case–control study. Journal of Gynecological Endocrinology. 2016; 32(2):52-55.
Sobande AA, Eskander M, Archibong EI. Complications of pregnancy and fetal outcomes in pregnant diabetic patients in a tertiary hospital in Saudi Arabia. WAJM. 2005;24(1):13-17.
Chanu M, Syiemleh AJ, Pradhan B, Devi RK. Clinical study of fetomaternal outcome of gestational diabetes mellitus. Journal of Dental and Medical Sciences. 2015;14(4):53-56.
Uma R, Balaji B, Ranjani H, Mahalakshmi M, Anjana RM, Unnikrishnan R. Pregnancy outcome of gestational diabetes mellitus using a structured model of care: WINGS project (WINGS-10). Journal of Obstetrics and Gynaecology Research. 2017;43(3): 468-475.
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