Prevalence and risk factors for gestational diabetes mellitus in Uganda comparing World Helaht Organization and International Association of Diabetes and Pregnancy study group detection criteria

Abstract

Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. The aim of this study was to compare GDM prevalence using the World Health Organization (WHO) criteria and the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in our population. We further compared the risk factors associated with GDM. The main aim was to determine whether the IADPSG criteria is suitable in our population. This cross-sectional study was conducted in a mixture of government and private hospitals and health centres in the urban, peri-urban and rural areas in Uganda where the prevalence of GDM in these health centres was largely unknown. The study targeted 649 Pregnant women in their 3rd trimester of gestation attending Antenatal Care Clinic (ANC) at any one of the Hospitals/Health Centres in Urban, Peri-Urban and Rural study sites. All eligible women underwent a standard oral glucose tolerance test with 75 g glucose, their fasting,1hour and 2hour post prandial glucose levels were taken. Glucose result analysis was categorised according to the diagnostic criteria of WHO and IADPSG. prevalence of GDM according to the IADPSG criteria was 324 (49.9%) at 95%CI [46.0-53.8] as compared to the WHO 47 (7.2%) at 95% CI [ 5.4-9.5]. After adjusting for factors associated with GDM burden for both criteria, Age group, BMI, Education, alcohol use and type of work were common factors for both approaches We report that prevalence of GDM is 49.9% among our participants according to the IADPSG diagnostic criteria which is significantly high (p<0.001). The IADPSG diagnostic criteria used in this study found prevalence of GDM 49.9% and determined the risk factors to be advanced maternal age, increased parity, BMI and alcohol use. The results of our study prove that IADPSG is capable of detecting more cases of GDM than the WHO. If adopted will result in reduced maternal and neonatal morbidities and improve maternal outcomes.