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.