Screening for gestational diabetes: evaluation of prevalence in age-stratified subgroups at Central hospital Warri Nigeria

Abstract

Background: The prevalence of gestational diabetes depends on the method of diagnosis as well as ethnic background. Maternal age has also been identified as a factor, but has not been given much attention. The notion of gestational prediabetes has also speculated, but is equally yet to be a focus in discussion. Aim: This work aimed at evaluating the screening for gestational diabetes in Central Hospital, Warri; to determine prevalence of gestational diabetes in the general population and in stratified age groups. The other objective was to investigate the effectiveness and use of the methods of diagnosis. Materials and Methods: This was a retrospective review of laboratory data of de-identified antenatal patients. Hospital records of gestational diabetes from 2013 to 2015 were obtained from the Central Hospital, Warri. Data collected included age of the de-identified patients, blood glucose results and whether the test was fasting or random. Other information was the month/year of test. A total of 3 589 results were analyzed. Results: Averaged prevalence of 5.85% is identified. Fasting blood sugar (FBS) measurement was used more and it also identified more positives (9%) compared to random blood sugar (<2%). On a dichotomous age group, prevalence of gestational diabetes appeared low in women below 25 years compared to those ≥26 years old. In a more stratification of age groups, potential antepartum prediabetes in pregnancy was lower in women above 40 years old relative to the younger age subpopulations (p < 0.000001). No significant variation was observed in level of usage of either method between months/years. Conclusion: There is an ongoing good practice of using affordable screening test, which is FBS. The significant finding was that there may be up to 9% prevalence of GDM and that this number may erroneously be lower if random blood glucose measurement is used. Another worthy observation was that the prevalence in stratified age groups was non-directional, especially as prediabetes appears higher in the younger age subpopulation.

Gestational diabetes management postpartum in primary healthcare facilities: Mini review update on Delta State Nigeria

“…It is worthy of note that it has become worrisome in some part of developing countries were they do practice selective screening, which ultimately could be attributed to resource-deficient low-mid income countries such as Nigeria. In some instances, the selection is based on patient's ability to pay for the screening test [18]. Whether this practice improves the level of patients identified with GDM is of interest to investigate.…”

“…Screening for GDM and its consequent diagnosis can successfully lead to interventions that are likely to reduce the incidence of macrosomia while possibly increasing the CS rate. Reduction of macrosomia is only an intermediate endpoint, with reduction of birth trauma and possibly neonatal metabolic disorders being the true goal of GDM diagnosis and treatment [1,18,22,23]. Evidence of other health benefits for the child or mother is not lacking [1], and this can be further picked up from the risk assessment and screening algorithm [4,9,10,20].…”

“…This narrative review was a progression of ongoing studies and started from preliminary evaluations' data that have been previously published [15][16][17][18][19]. There were separate two clinical audits done at secondary and tertiary health facilities in the state [18,19]; plus one expository review [16].…”

“…This narrative review was a progression of ongoing studies and started from preliminary evaluations' data that have been previously published [15][16][17][18][19]. There were separate two clinical audits done at secondary and tertiary health facilities in the state [18,19]; plus one expository review [16]. This narrative being a progression of the work attempts to bring all the findings in terms of capacity of the PHC facilities to screen and manage GDM.…”

“… Lack of register [19]; and/or complete documentation indicated by 194 tests done in September and October 2013 compared to over 640 during the same period of following years [18].…”