Abstract:
Background: Gestational diabetes mellitus (GDM) is a substantial and growing health
concern in many parts of the world. It-also has serious, long-term consequences for both baby
and mother, including a predisposition to obesity, metabolic syndrome, and diabetes later in
life. Early detection and intervention identifies women with high risk and offers primary
prevention for women with this condition and their babies. The prevalence may range from 3-
19% of all pregnancies depending on the population studied and the diagnostic tests
employed. There is no recent study which has been done to find the prevalence of GDM and
associated factors in our country.
Objective: To determine the prevalence of GDM associated factors and pregnancy outcome
in women attending Antenatal Clinic at Muhimbili National Hospital.
Methodology: A structured questionnaire was used to obtain participants' particulars
including demographic characteristics including age of patients, marital status, gravidity and
gestation age. Information on associated factors was also collected which included previous
obstetric history and history of diabetes in the family. Blood samples for Random Blood
Glucose (RBG) measurement was taken from all participants and 2hrs oral glucose tolerance
test was done to those participants who were found to have impaired RBG. The diagnosis of
GDM was obtained using WHO criteria. The pregnancy outcome of among women with
GDM was also looked upon.
Results: A total of 549 participants were interviewed and examined 61 (11 %) had impaired
RBG. Out of them, 2hrs OGTT was done in 59 participants and 27(45.8%) were found to
have GDM. The overall prevalence ofGDM was found to be 4.9% (27/549).
It was noted that among investigated factors participants with history of diabetes in the first
degree relatives were three times likely to have GDM than those with no family history of diabetes in the first degree relatives (OR=2.5; 95%CI: 1.14-5.51). All other variable were not
significant in bivariate analysis.
"Out of 549- participants 505(92%) delivered" within the "study-period. Clients with GDM
26/27(96.3%) delivered during the study period.
Delivery of big baby was found to have significantly positive association with GDM (p-value
<-0.001). Delivery of still birth as well as premature baby did not show association with
GDM. Delivery by caesarean section 12/186(6.5%) was high for GDM though this was not
statistically significant.
Conclusion and recommendation: There is relatively high prevalence of GDM in women
attending antenatal clinic at Muhimbili National Hospital. This is a preventable disease, so
efforts should be initiated to stop further increase in its prevalence.
