Gestational diabetes using diverse diagnostic criteria, risk factors including dietary intakes, pregnancy outcomes and postpartum glycemic status: a nested case-control study in Ghana

Abstract

Organization delivery (aOR:4.01 CI:1.08-14.76) and antenatal care in a primary facility (aOR:4.951 CI:1.87-3.76). A unit rise in blood glucose significantly increased maternal blood loss and birthweight. Adjusting for covariates, adverse birth outcomes were perineal tear (Aor:2.91 CI:1.08-5.57) and birth asphyxia (aOR:3.24 CI:1.01-10.44). Cesarean section (aOR:1.9 CI:0.97-3.68), large for gestational age (aOR:2.7 CI:0.86-5.05) and newborn resuscitation (aOR:2.91 CI 0.94-9.01) were significant at 10%. At 12 weeks postpartum, 30% of the GDM cases were unable to achieve euglycemia. Different estimates could be obtained if other diagnostic criteria were used. ConclusionsFindings show an increasing prevalence of GDM in peri-urban and rural settings highlighting the need to strengthen primary facilities to test and refer cases for management. Diet and adiposity are key risk factors necessitating lifestyle modification interventions focusing on nutrition education and weight control. GDM-exposed newborn need close monitoring as birth asphyxia which is a key outcome is likely to compromise neonatal survival. Postpartum follow-up of cases is crucial to avert transition of GDM into active diabetes.