Gestational Diabetes in a Tertiary Healthcare Centre at Abeokuta, South Western Nigeria: A Five Year Retrospective Review

Abstract

Background: Women with gestational diabetes are at increased risk of adverse perinatal and maternal morbidities. Hence early detection and management of this condition is vital to ensure better outcome for both mother and baby [1,2]. Approximately 7% of all pregnancies are complicated by diabetes mellitus, resulting in more than 2000000 cases annually.1 The prevalence of gestational diabetes mellitus (GDM) ranges from 1 to 14% of all pregnancies, depending on the population studied and the diagnostic test employed [8,9]. In the recent years, there had been a rapid rise in the incidence of diabetes in pregnancy. This is due to the increasing number of women in the reproductive age population with pre-gestational diabetes (type 2 DM) and increase in the number of women being diagnosed with gestational diabetes [2]. Aim: To determine the incidence of gestational diabetes mellitus at Federal Medical Centre, Abeokuta and to evaluate the feto-maternal outcome of their pregnancies. Materials and Methods: This study is a 5 year retrospective review of gestational diabetes mellitus cases at the Federal Medical Centre, Abeokuta (between 2009 to 2013) as well as the outcomes of these pregnancies. A proforma was used to collect data from case notes of all gestational diabetes mellitus (GDM) cases diagnosed within the stated period. All pregnant women in 24 weeks of gestation and above who are considered to be at risk after undergoing preliminary clinical examination were given a 75g oral glucose load, using the WHO standardized oral glucose tolerance test [4,5]. Gestational diabetes mellitus was diagnosed if 2 hour plasma glucose was ≥140 mg/dl. Results: The incidence rate of gestational diabetes mellitus was found to be 1.13% of the pregnancies. Overall, there was a preponderance of GDM mothers with tertiary level of education (34.15%). The majority of mothers with GDM in this study, had maternal age ≥31yrs (78.1%), increased body mass index ≥25 (82.9%) and previous intrauterine fetal death (28.3%). Many of the women (48.78%) had parity of 2-3 and various complications were seen in 43.9% of mothers and 22% of the newborns. Caesarean section as the mode of delivery was significantly high at 61%. Conclusion: The morbidities associated with gestational diabetes are still enormous and timely screening of mothers could be beneficial in reducing the complications seen in gestational diabetes mellitus mothers.