Prevalence of hyperglycaemia first detected during pregnancy and subsequent obstetric outcomes at St. Francis Hospital Nsambya

被引:17
作者
Nakabuye B. [1 ,2 ]
Bahendeka S. [2 ,3 ]
Byaruhanga R. [1 ,2 ]
机构
[1] Department Obstetrics and Gynaecology, St. Francis Hospital Nsambya, P.O.Box 7146, Kampala
[2] Mother Kevin Post Graduate Medical School, Uganda Martyrs University, P.O.Box 7146, Kampala
[3] Department of Internal Medicine, Mother Kevin Post Graduate Medical School, Uganda Martyrs University, P.O.Box 7146, Kampala
关键词
Hyperglycaemia; Screening and pregnancy;
D O I
10.1186/s13104-017-2493-0
中图分类号
学科分类号
摘要
Background: Women with hyperglycaemia detected during pregnancy are at greater risk for adverse pregnancy outcomes. Data on hyperglycaemia in pregnancy in sub-Saharan Africa is scanty and varied depending on the populations studied and the methodologies used to define hyperglycaemia in pregnancy. With the recent 2013 World Health Organisation (WHO) diagnostic criteria and classification, there is yet no sufficient data on the prevalence of hyperglycaemia in sub-Saharan Africa. The objective was to determine the prevalence of Hyperglycaemia first detected during pregnancy and subsequent obstetric outcomes among patients attending antenatal care (ANC) at St. Francis Hospital Nsambya. Methods: A prospective cohort study. All women with no history of diabetes mellitus attending at or after 24 weeks gestation were eligible to participate in the study. Participants underwent a standard 75 g oral glucose tolerance test (OGTT) after an informed written consent. The primary outcome was diagnosis of hyperglycaemia. Enrolled participants were followed up to delivery to assess obstetric outcomes (secondary outcomes were birth weight, neonatal admission, maternal genital trauma, delivery mode, neonatal and maternal status at discharge). Results: 251 women were screened between December 2013 and February 2014. The prevalence of hyperglycaemia first detected in pregnancy was 31.9%. We found 23.8 % of women with hyperglycaemia had no known risk factor. Macrosomia was the only obstetric outcome that was significantly associated with hyperglycaemia. Conclusion: The prevalence of hyperglycaemia first detected in pregnancy was high in the studied population. Clinicians, therefore, should become more vigilant to screen for the condition. Selective screening may miss 23.8% of pregnant women with hyperglycaemia. However the cost/benefit implications of screening strategy and the recent 2013 WHO diagnostic criteria need to be studied in our setting. © 2017 The Author(s).
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共 41 条
[1]  
Butte N.F., Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus, Am J Clin Nutr, 71, 5, pp. 1256s-1261s, (2000)
[2]  
Dodd J.M., Crowther C.A., Antoniou G., Baghurst P., Robinson J.S., Screening for gestational diabetes: the effect of varying blood glucose definitions in the prediction of adverse maternal and infant health outcomes, Aust NZ J Obstet Gynaecol, 47, 4, pp. 307-312, (2007)
[3]  
Schmidt M.I., Duncan B.B., Reichelt A.J., Branchtein L., Matos M.C., E Forti A.C., Et al., Gestational diabetes mellitus diagnosed with a 2-h 75-g oral glucose tolerance test and adverse pregnancy outcomes, Diabetes Care, 24, 7, pp. 1151-1155, (2001)
[4]  
Chodick G., Elchalal U., Sella T., Heymann A., Porath A., Kokia E., Et al., The risk of overt diabetes mellitus among women with gestational diabetes: a population-based study, Diabet Med, 27, 7, pp. 779-785, (2010)
[5]  
Kim C., Newton K.M., Knopp R.H., Gestational diabetes and the incidence of type 2 diabetes a systematic review, Diabetes Care, 25, 10, pp. 1862-1868, (2002)
[6]  
Kaaja R.J., Greer I.A., Manifestations of chronic disease during pregnancy, JAMA, 294, 21, pp. 2751-2757, (2005)
[7]  
Dabelea D., The predisposition to obesity and diabetes in offspring of diabetic mothers, Diabetes Care, 30, pp. S169-S174, (2007)
[8]  
Ornoy A., Growth and neurodevelopmental outcome of children born to mothers with pregestational and gestational diabetes, Pediatr Endocrinol Rev: PER., 3, 2, pp. 104-113, (2005)
[9]  
Diabetes atlas, (2012)
[10]  
Abegunde D.O., Mathers C.D., Adam T., Ortegon M., Strong K., The burden and costs of chronic diseases in low-income and middle-income countries, Lancet, 370, 9603, pp. 1929-1938, (2007)