DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20185424

Gestational diabetes mellitus and obstetric outcomes in a Ghanaian community

Ahmed Tijani Bawah, Robert Amadu Ngala, Mohammed Mustapha Seini, Francis Abeku Ussher, Huseini Alidu, Joshua Dokurugu Kwame Wumbee, Francis Agyeman Yeboah

Abstract


Background: This study was aimed at evaluating effect of Gestational diabetes mellitus (GDM) and maternal characteristics on pregnancy outcomes. GDM has several risk factors including; advanced maternal age, ethnic background, obesity and family history of diabetes mellitus. These pregnancy complications are associated with fetal morbidity and mortality and may lead to macrosomia and shoulder dystocia. Others are stillbirth, miscarriages, preterm and small for gestational age babies.

Methods: This was a retrospective case-control study which compared maternal characteristics and pregnancy outcome among pregnant women with and without GDM. Diagnosis of GDM was done in accordance with the American Diabetes Association (ADA) criteria. Weight and height were determined and Body mass index (BMI) calculated. Pregnancy outcome was determined at the end of pregnancy and information on maternal characteristics obtained using questionnaire and patient folders.

Results: Those who developed GDM were significantly older (OR=1.772; 95% CI=1.432-2.192; P<0.0001) and had higher BMI (OR=1.637; 95% CI=1.004-1.289; P=0.044) than those who did not. A significant number of those who developed GDM also had stillbirths (OR= 5.188; 95% CI=1.093-24.613; p=0.038) and cesarean deliveries (OR=14.362; 95% CI=3.661-56.335; p= 0.001).

Conclusions: Women who develop GDM are more likely to deliver stillborn or macrosmic babies and may require surgical intervention in order to have normal deliveries.


Keywords


Cesarean operation, Gestational diabetes mellitus, Stillbirth

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References


Coustan DR. Gestational diabetes mellitus. Clinic Chemist. 2013;59(9):1310-21.

Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, et al. National standards for diabetes self-management education. Diabet Care. 2009;32(Supplement 1):S87-94.

Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clinic Investigat. 2005;115(3):485-91.

Miller HC. The effect of diabetic and prediabetic pregnancies on the fetus and newborn infant. J Pedia. 1946;29:455-61.

Carrington ER, Shuman CR, Reardon HS. Evaluation of the prediabetic state during pregnancy. Obstet Gynecol. 1957;9(6):664-9.

O'Sullivan JB. Criteria for the oral glucose tolerance test in pregnancy. Diabet. 1964;13:278-85.

Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program. Diabet Care. 2005;28(3):579-84.

Cheung NW, Byth K. Population health significance of gestational diabetes. Diabet Care. 2003;26(7):2005-9.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabet Care. 2014;37(Supplement 1):S81-90.

Ozumba BC, Obi SN, Oli JM. Diabetes mellitus in pregnancy in an African population. Int J Gynecol Obstet. 2004;84(2):114-9.

Oppong SA, Ntumy MY, Amoakoh‐Coleman M, Ogum‐Alangea D, Modey‐Amoah E. Gestational diabetes mellitus among women attending prenatal care at Korle‐Bu Teaching Hospital, Accra, Ghana. Int J Gynecol Obstet. 2015;131(3):246-50.

Teh WT, Teede HJ, Paul E, Harrison CL, Wallace EM, Allan C. Risk factors for gestational diabetes mellitus: implications for the application of screening guidelines. Aust New Zealan J Obstet Gynaecol. 2011;51(1):26-30.

Ross G. Gestational diabetes. Aust Family Physic. 2006;35(6):392.

England LJ, Levine RJ, Qian C, Soule LM, Schisterman EF, Yu KF, et al. Glucose tolerance and risk of gestational diabetes mellitus in nulliparous women who smoke during pregnancy. Am J Epidemiol. 2004;160(12):1205-13.

Kjos SL, Buchanan TA, Greenspoon JS, Montoro M, Bernstein GS, Mestman JH. Gestational diabetes mellitus: the prevalence of glucose intolerance and diabetes mellitus in the first two months post-partum. Am J Obstet Gynecol. 1990;163(1):93-8.

Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabet Care. 2002;25(10):1862-8.

Barden A, Singh R, Walters BN, Ritchie J, Roberman B, Beilin LJ. Factors predisposing to pre-eclampsia in women with gestational diabetes. J Hypertension. 2004;22(12):2371-8.

Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics. 2005;115(3):e290-6.

Gilmartin A, Ural S, Repke J. Gestational diabetes mellitus. Rev Obstet Gynecol. 2007;1(3):129-34.

Maas AH, van’t Hof AW, de Boer MJ. Cardiovascular risk in women after metabolic complications in pregnancy. Netherlands Heart J. 2007;15(12):415-7.

Langer O, Yogev Y, Most O, Xenakis EM. Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol. 2005;192(4):989-97.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabet Care. 2014;37(Supplement 1):S81-90.

Asare-Anane H, Ofori AT, Amanquah SD. Risk factors for gestational diabetes mellitus among Ghanaian women at the Korle-Bu Teaching Hospital. Risk. 2014;4(12).

Weller K. Diagnosis and management of gestational diabetes. Am Fam Physic. 1996;53(6):2053-2057; 2061-2052.

Amraei A, Azemati M. Metabolic status of women with gestational diabetes mellitus six months after delivery. Res J Biological Sci. 2007;2(1):104-7.

Kelly L, Evans L, Messenger D. Controversies around gestational diabetes. Practical information for family doctors. Canad Fam Physic. 2005;51(5):688-95.

Keshavarz M, Cheung NW, Babaee GR, Moghadam HK, Ajami ME, Shariati M. Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diabet Res Clinic Pract. 2005;69(3):279-86.

Fadl HE, Östlund IK, Magnuson AF, Hanson US. Maternal and neonatal outcomes and time trends of gestational diabetes mellitus in Sweden from 1991 to 2003. Diabet Med. 2010;27(4):436-41.