Prevalence and Predictors of Gestational Diabetes Mellitus in <scp>Sub‐Saharan</scp> Africa: A 10‐Year Systematic Review

Objectives: There are controversies about screening strategy and cut-off levels for gestational diabetes mellitus (GDM). Here, we aimed to identify optimal cut-off values for 50-gram oral glucose tolerance testing (OGTT) in high and low risk pregnant women. Methods: A total of 500 patients who underwent two step OGTT were divided into two groups as GDM (n=31) and controls (n=469). Moreover, patients were grouped as high (n=114) and low risk (n=386) for GDM. Having≥2 risk factors such as family history of type-2 diabetes, obesity, glucosuria, previous history of GDM, macrosomia and diabetic complications were accepted as high risk. Demographic data, OGTT results, birth characteristics were recorded and compared between groups. A cut-off value for 50-gram OGTT was evaluated in low and high risk groups. Results: The 50-gram OGTT value above 140 mg/dL discriminated GDM with 100% sensitivity and 92.11% specificity in all patients (AUC=0.969, P<0.001). The prevalence of GDM was 19.3% in high and 2.3% in low risk group. The 50-gram OGTT value above 140 mg/dL discriminated GDM with 100% sensitivity and 94.57% specificity in high risk patients (AUC=0.992, P<0.001). Furthermore, 50-gram OGTT value above 149 mg/dL discriminated GDM with 100% sensitivity and 93.63% specificity in low risk patients (AUC=0.976, P<0.001). Conclusions: Although screening in low risk population is a debating issue worldwide, our local guidelines still recommend screening all pregnant women. We suggest that performing 100-gram OGTT only in patients who have higher values than 149 mg/dL in 50-gram OGTT can be an alternative screening strategy in low risk group.

show abstract

Prevalence, and Associated Factors of Cephalopelvic Disproportion Among Pregnant Women Attending Delivery Services at Wachemo University, Nigist Elleni Mohammed Memorial Referral Hospital, Southern Ethiopia

Borsamo,

Ermias,

Asmare

et al. 2024

Preprint

View full text Add to dashboard Cite

Introduction: Cephalopelvic disproportion (CPD) is a condition in which the baby's head is too large or the mother's pelvis is too small, making it difficult for the baby to pass through the birth canal during labor even if the uterine contraction is strong enough. This can lead to prolonged or obstructed labor, which poses serious risks to both the mother and the baby. The magnitude and risk factors contributing to cephalopelvic disproportion in Ethiopia are poorly understood. Objectives To assess the prevalence and associated factors of cephalopelvic disproportion among pregnant women attending delivery service at Wachemo University Nigist Elleni Mohammed Memorial Referral Hospital, Southern Ethiopia. Methods An institutional-based quantitative cross-sectional study design was implemented on 384 randomly selected pregnant women attending delivery service at Wachemo University Nigist Elleni Mohammed Memorial Referral Hospital from September-December 2023. The primary data were collected by using structured questionnaires and checklists. The history taking, anthropometric measurements, physical examination, and CPD diagnosis were performed by the gynecologist and obstetricians. The data were collected by the four BSc midwives under strict supervision. After being carefully checked for the completeness, accuracy, and validity of each questionnaire, the data were entered into Epi-data and then exported to SPSS version 25 for analysis. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed. Results The prevalence of cephalopelvic disproportion was 13.8%. The decrease in one centimeter of the maternal height triples the chance of developing the CPD [AOR = 3 (95% CI: 1.76–5.24)]. A unit increment in fetal head circumference doubles the likelihood of the developing the CPD [AOR = 2 (95% CI: 1.47–4.95)]. One gram increment in fetal weight increases the chance of developing CPD by 3.5 folds [AOR = 3.8 (95% CI: 1.12–5.88)]. Maternal diabetes mellitus [AOR = 2.8 (95% CI: 1.17–5.32)] was another significantly contributing factor to CPD. Conclusion The prevalence of cephalopelvic disproportion was high. The significantly contributing factors for CPD were short maternal height, large fetal birth weight, wider fetal head circumference, and maternal diabetes mellitus. Adequate younghood nutrition, proper dietary intake during pregnancy, complete antenatal service, and controlling blood glucose level were recommended.

show abstract

Prevalence and Predictors of Gestational Diabetes Mellitus in Sub‐Saharan Africa: A 10‐Year Systematic Review

Cited by 4 publications

References 66 publications

Tackling Gestational Diabetes in Africa: A Public Health Priority

Tackling Gestational Diabetes in Africa: A Public Health Priority

Could different cut-off values be used for 50-gram glucose tolerance test in low and high risk groups?

Prevalence, and Associated Factors of Cephalopelvic Disproportion Among Pregnant Women Attending Delivery Services at Wachemo University, Nigist Elleni Mohammed Memorial Referral Hospital, Southern Ethiopia

Contact Info

Product

Resources

About