Gestational Diabetes Mellitus in a Nigerian Antenatal Population
AbstractContext: Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity, with onset or first recognition during the index pregnancy. Previous studies of the problem of pregnancy and diabetes in parts of Nigeria failed to distinguish between GDM (as defined) and pregnancy occurring in a previously diagnosed diabetic. Thus the actual prevalence of GDM in Nigeria antenatal populations is not known.
Objectives: To determine the prevalence of gestational diabetes mellitus and the pattern, behaviour, level of care and outcome of GDM pregnancies in a Nigerian antenatal population.
Study Design & Setting: Cohort observational study in a university teaching hospital.
Main Outcome Measures: Prevalence of GDM, glycaemic profile of GDM pregnancy, maternal and fetal complications, mode of delivery and outcome of GDM pregnancies.
Results: The GDM prevalence was 2.98 per 1000 pregnancies. Maternal age and gestational age at diagnosis (mean + SD) were 31.0 ± 2.4 years and 23.88 ± 8.2 weeks respectively. Fasting venous blood glucose level at diagnosis was 7.76 ± 1.6 mmol/L while the cumulative mean FVBG throughout pregnancy was 6.56 ± 0.79 mmol/L. Pre-eclampsia 26.7%, mid-trimester abortion 6.7%, intrauterine fetal death (IUFD) 6.7% were the major antenatal complications. Caesarian section rate was 10%, gestational age at delivery - 37.55 ± 1.94 weeks and birthweight - 3.75 ± 0.55 kg.
Conclusion: Prevalence of GDM in this antenatal population remains low (but within the global range of 0.15 — 3.0%). Overall care and metabolic control of GDM pregnancies in our population remain sub-optimal with attendant poor feto-maternal outcomes.
(Tropical Journal of Obstetrics and Gynaecology: 2001, 18(2): 56-60)
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