Prevalence of Gestational Diabetes Mellitus and Maternal and Fetal Outcomes at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria

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.

The Case for Early and Universal Screening for Gestational Diabetes Mellitus: Findings from 9314 Pregnant Women in a Major City in Nigeria

“…While a 2001 study in a tertiary institution in the south-south of Nigeria recorded a GDM prevalence of 0.3% [14], a recent systematic review and meta-analysis of GDM studies in for the and 5.5% in the south-south [15]. Even studies in the same geographical region have taken a wide range of values depending on the study design, diagnostic criteria used and the time of the study [10,[16][17][18].…”

Test characteristics of glycated albumin in the diagnosis of gestational diabetes mellitus

“…7 In Nigeria, a prevalence of 7.7% has been reported GDM in Sokoto, Northern Nigeria 8 and a prevalence of 10.5% has been reported in Port Harcourt, Southern Nigeria. 9 The babies of women with GDM may be premature, growth-restricted, or large-for-date. 10 They may suddenly die in utero or have birth injuries from shoulder dystocia and instrumental delivery.…”

“…16 Other risk factors for GDM are maternal age, previous unexplained stillbirth, and previous GDM. 9,17 The morbidities associated with GDM can be significantly reduced if the women are diagnosed with GDM early and appropriate treatment is instituted. The Oral glucose tolerance test is the gold standard for GDM screening in pregnant women.…”

Pregnancy Outcome Among Women with Diabetes Mellitus in Pregnancy at a Tertiary Health Centre in North-Western Nigeria

“…Pregestational diabetes (PGDM) is the term used to refer to type 1 and type 2 diabetes occurring before pregnancy while gestational diabetes (GDM) is the one that presents for the first time in pregnancy (John, Alegbeleye, & Otoide, 2015;Fraser, & Farell, 2011;Wokoma, John, & Enyindah, 2001;Buchanan, & Xiang, 2005). Diabetes Mellitus in pregnancy could be associated with an increased risk of recurrent miscarriages, congenital abnormalities, intrauterine death, fetal macrosomia, early onset of hypertensive diseases in pregnancy, difficult deliveries and increased operative delivery as well as birth injuries (John, Alegbeleye, & Otoide, 2015;Lucas, 2001;John et al, 2020).…”