Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana
The surge in gestational diabetes mellitus (GDM) globally requires a health system tailored approach towards prevention, detection and management. We estimated the prevalence of GDM using diverse recommended tests and diagnostic thresholds, and also assessed the risk factors and obstetric outcomes,...
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| Format: | Article |
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MDPI AG
2021-05-01
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| Series: | Clinics and Practice |
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| Online Access: | https://www.mdpi.com/2039-7283/11/2/39 |
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| author | Faith Agbozo Abdulai Abubakari Francis Zotor Albrecht Jahn |
| author_facet | Faith Agbozo Abdulai Abubakari Francis Zotor Albrecht Jahn |
| author_sort | Faith Agbozo |
| collection | DOAJ |
| description | The surge in gestational diabetes mellitus (GDM) globally requires a health system tailored approach towards prevention, detection and management. We estimated the prevalence of GDM using diverse recommended tests and diagnostic thresholds, and also assessed the risk factors and obstetric outcomes, including postpartum glycemia. Using a prospective cohort design, 446 singleton pregnant women without pre-existing diabetes did GDM tests in five hospitals in Ghana from 20–34 weeks using fasting plasma glucose (FPG), one-hour and 2-h oral glucose tolerance test (OGTT). Birth outcomes of 403 were assessed. GDM was diagnosed using six international diagnostic criteria. At 12 weeks postpartum, impaired fasting glucose (6.1–6.9 mmol/L) and diabetes (FPG ≥7.0 mmol/L) were measured for 100 women. Per FPG and 2-h OGTT cut-offs, GDM prevalence ranged between 8.3–23.8% and 4.4–14.3%, respectively. Risk factors included overweight (OR = 2.13, 95% CI: 1.13–4.03), previous miscarriage (OR = 4.01, 95% CI: 1.09–14.76) and high caloric intake (OR = 2.91, 95% CI: 1.05–8.07). Perineal tear (RR = 2.91, 95% CI: 1.08–5.57) and birth asphyxia (RR = 3.24, 95% CI: 1.01–10.45) were the associated perinatal outcomes. At 12 weeks postpartum, 15% had impaired fasting glucose, and 5% had diabetes. Tackling modifiable risk factors is crucial for prevention. Glycemic monitoring needs to be integral in postpartum and well-child reviews. |
| first_indexed | 2024-03-10T11:39:13Z |
| format | Article |
| id | doaj.art-3993d412cddb4becb9d17e01c4a012d7 |
| institution | Directory Open Access Journal |
| issn | 2039-7283 |
| language | English |
| last_indexed | 2024-03-10T11:39:13Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj.art-3993d412cddb4becb9d17e01c4a012d72023-11-21T18:37:06ZengMDPI AGClinics and Practice2039-72832021-05-0111225727110.3390/clinpract11020039Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in GhanaFaith Agbozo0Abdulai Abubakari1Francis Zotor2Albrecht Jahn3Department of Family and Community Health, School of Public Health, University of Health and Allied Health Sciences, Ho, Ghana, Private Mail Bag 31 Ho, GhanaPublic Health Department, University for Development Studies, Tamale Ghana, Tamale P.O. Box TL 1350, GhanaDepartment of Family and Community Health, School of Public Health, University of Health and Allied Health Sciences, Ho, Ghana, Private Mail Bag 31 Ho, GhanaHeidelberg Institute of Global Health, University Hospital Heidelberg Germany, Im Neuenheimer Feld 130.3, 60120 Heidelberg, GermanyThe surge in gestational diabetes mellitus (GDM) globally requires a health system tailored approach towards prevention, detection and management. We estimated the prevalence of GDM using diverse recommended tests and diagnostic thresholds, and also assessed the risk factors and obstetric outcomes, including postpartum glycemia. Using a prospective cohort design, 446 singleton pregnant women without pre-existing diabetes did GDM tests in five hospitals in Ghana from 20–34 weeks using fasting plasma glucose (FPG), one-hour and 2-h oral glucose tolerance test (OGTT). Birth outcomes of 403 were assessed. GDM was diagnosed using six international diagnostic criteria. At 12 weeks postpartum, impaired fasting glucose (6.1–6.9 mmol/L) and diabetes (FPG ≥7.0 mmol/L) were measured for 100 women. Per FPG and 2-h OGTT cut-offs, GDM prevalence ranged between 8.3–23.8% and 4.4–14.3%, respectively. Risk factors included overweight (OR = 2.13, 95% CI: 1.13–4.03), previous miscarriage (OR = 4.01, 95% CI: 1.09–14.76) and high caloric intake (OR = 2.91, 95% CI: 1.05–8.07). Perineal tear (RR = 2.91, 95% CI: 1.08–5.57) and birth asphyxia (RR = 3.24, 95% CI: 1.01–10.45) were the associated perinatal outcomes. At 12 weeks postpartum, 15% had impaired fasting glucose, and 5% had diabetes. Tackling modifiable risk factors is crucial for prevention. Glycemic monitoring needs to be integral in postpartum and well-child reviews.https://www.mdpi.com/2039-7283/11/2/39gestational diabetes mellitushyperglycemia in pregnancyblood glucosepregnancyprevalencerisk factors |
| spellingShingle | Faith Agbozo Abdulai Abubakari Francis Zotor Albrecht Jahn Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana Clinics and Practice gestational diabetes mellitus hyperglycemia in pregnancy blood glucose pregnancy prevalence risk factors |
| title | Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana |
| title_full | Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana |
| title_fullStr | Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana |
| title_full_unstemmed | Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana |
| title_short | Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana |
| title_sort | gestational diabetes mellitus per different diagnostic criteria risk factors obstetric outcomes and postpartum glycemia a prospective study in ghana |
| topic | gestational diabetes mellitus hyperglycemia in pregnancy blood glucose pregnancy prevalence risk factors |
| url | https://www.mdpi.com/2039-7283/11/2/39 |
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