Prevalence Of Gestational Diabetes Among Pregnant Women Attending Antenatal Care

Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable severity, with onset or first recognition during pregnancy. GDM is associated with increased risk of poor outcomes for the pregnancy and is a risk factor for subsequent diabetes later in life. It is important to determine the prevalence and risk factors for GDM in our centre as this may influence policy formulation regarding screening and diagnosis of the clinical condition.

To ascertain the prevalence, pattern of glucose tolerance and risk factors for GDM among pregnant women attending antenatal clinic in Jos University Teaching Hospital, Jos.  A descriptive cross sectional study. Two hundred and sixty five (265) pregnant women were recruited by simple random sampling into the study. Patients with known diabetes were excluded. However, two hundred and fifty three (253 ) women participated in the study and were screened between 24 ? 28 weeks of pregnancy with a 50g, 1- hour glucose challenge test (GCT). Those with plasma glucose concentration of >7.8mmol/l were given 75g oral glucose tolerance test (OGTT) to confirm the diagnosis. Plasma glucose measurements were performed with glucose oxidase method using a spectrophotometer (optima, model SP-100). GDM was diagnosed according to the WHO criteria.

All relevant data including demographic information, obstetric history, and risk factors for GDM, GCT and OGTT results were collected for further statistical analysis.Of the 253 subjects, 28 (11.1% ) had positive GCT ? 7.8 mmol/l. Twenty one (21 ) cases of GDM were detected, giving a prevalence rate of 8.3% (95% CI, 5.2-12.4) in the studied population. Among the GDM cases, 17 (6.7%) had IGT while 4 (1.6%) had overt diabetes. The pattern of plasma glucose response (glucose tolerance) in the study population indicated that 232 (91.7%) had normal glucose tolerance, 6.7% had IGT while 1.6% had overt diabetes. Increasing or older age was found to be associated with GDM (31.2±5.8 years versus 28.6±5.6 years respectively) (p < 0.05). Bivariate analysis showed that age >31 years, obesity, previous fetal macrosomia, current polyhydramnios and glycosuria (p values < 0.05) were significantly associated with GDM. After multivariate analysis (multiple logistic regression), only previous history of fetal macrosomia was found to be an independent risk factor for GDM (adjusted OR 11.1; 95% CI 2.93-42.12, P=0.0004). Prevalence of GDM (8.3%) in this antenatal population was relatively high and women with previous history of fetal macrosomia should be routinely screened for GDM. A larger study will be needed to assess the correlation or otherwise of other traditional risk factors with GDM.