Background: Gestational diabetes mellitus (GDM) is a global health challenge and is known to affect pregnancy adversely. Glycosylated haemoglobin (HbA1c) level reflect long term glycaemic control and is a more accurate measure than Fasting Plasma Glucose and post prandial plasma glucose level. Aims and Objectives: To determine the levels of HbA1c, perinatal outcomes and the relationship between maternal HbA1c level and perinatal outcomes in women with GDM at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a longitudinal study of 80 pregnant women from 36 weeks of gestation with GDM attending the antenatal clinic of the University of Port Harcourt Teaching Hospital (UPTH). Blood samples from all consenting pregnant women were collected and sent to Original Research Article Ezeaku et al.; JAMMR, 32(7): 54-63, 2020; Article no.JAMMR.56143 55 the Chemical Pathology laboratory to determine the HbA1c level. The blood samples from the babies were also sent to determine the random plasma glucose (RPG) level. A structured proforma was used to obtain socio-demographic characteristics and other information. Data collected was analyzed with SPSS version 22.0. Results: The mean age of the women was 32.58 ± 4.95 years. A total of 57 (71.3%) women with GDM had elevated HbA1c levels (≥ 6.5%). Fetal macrosomia occurred in 17.5%, while 8.8% had birth asphyxia. The perinatal mortality ratio was 1.3%. There was a statistically significant relationship between HbA1c levels and neonatal hypoglycemia and perinatal mortality (p <0.05). Conclusion: Despite the higher proportions of adverse perinatal outcomes occurring among those with elevated HbA1c levels, only neonatal hypoglycemia and perinatal mortality were significantly associated with elevated HbA1c.

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Relationship between Glycosylated Haemoglobin Levels and Perinatal Outcome among Women with Gestational Diabetes Mellitus at the University of Port Harcourt Teaching Hospital, Nigeria

Background/Aims An increasing prevalence rate of gestational diabetes mellitus has been recorded in developing countries including Nigeria, yet it is largely a preventable condition. There is a lac...

Perception of risk and prevention of gestational diabetes mellitus among pregnant women in Ibadan, Nigeria

Objectives: Dysglycemia is a common metabolic alteration during pregnancy with adverse effects on both mother and fetus. This is related to the fact that pregnancy is associated with insulin resistance which is a harbinger for hyperglycemia. This study was carried out to find out the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Calabar area using International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic values. Material and Methods: This was a prospective, observational, cross-sectional study among pregnant women attending antenatal care in four health facilities in Calabar and adjoining areas conducted from September 2018 to August 2019. All consenting pregnant women were given 75 g glucose in 250–300 mL of water after 8–10 h overnight fast, without regard to the presence or absence of GDM risk factors. GDM diagnosis was made if any of the following glucose values were met or exceeded: (1) Fasting >92 mg/dl, (2) 1 h post-glucose load >180 mg/ dl, and (3) 2 h post-glucose load >153 mg/dl. Data were analyzed using IBM Statistical Package for the Social Sciences version 20.0 and results were presented using tables and a Venn diagram. Results: There were 345 pregnant women aged 18–50 (28.7 ± 6.3) years at 24–41 (29.6 ± 4.1) completed weeks of gestation. GDM was diagnosed in 48 (13.9%) women. Fasting plasma glucose cutoff diagnosed 81% while 37.5% and 50.0% met the diagnostic cutoff for 1 h and 2 h, respectively, and 15 (31.3%) women were positive for all three diagnostic cutoffs. Diabetes mellitus in a first-degree relative was the most common risk factor identified while hypertension in a first-degree relative and history of GDM was the least. Some 36.5% of women had no identifiable risk factors. Those who had positive fasting plasma glucose only (6.1%) were more than twice those diagnosed by 1 and 2 h only (2.6%) combined. The number of women with glucose values in the diabetic range was 6 (1.72%) but was classified as GDM since they were not previously known diabetics. Conclusion: This study has shown that the prevalence of GDM is 13.9% among women in Calabar and environs using the IADPSG criteria. Fasting plasma glucose can identify more than twice GDM patients than 1 and 2 h values combined. GDM still remains a major health issue among pregnant women hence there should be a national policy on routine screening for GDM with more studies being encouraged to determine the preferred glucose cutoff among Nigerians.

Oral glucose tolerance outcomes among pregnant women receiving antenatal care in Calabar and environs – A pilot study

Background: Women with gestational diabetes are at increased risk of adverse perinatal and maternal morbidities. Hence early detection and management of this condition is vital to ensure better outcome for both mother and baby [1,2]. Approximately 7% of all pregnancies are complicated by diabetes mellitus, resulting in more than 2000000 cases annually. 1 The prevalence of gestational diabetes mellitus(GDM) ranges from 1 to 14% of all pregnancies, depending on the population studied and the diagnostic test employed [8,9]. In the recent years, there had been a rapid rise in the incidence of diabetes in pregnancy. This is due to the increasing number of women in the reproductive age population with pre-gestational diabetes (type 2 DM) and increase in the number of women being diagnosed with gestational diabetes [2]. Original Research Article Chukwunyere et al.; IJTDH, 7(1): 23-31, 2015; Article no.IJTDH.2015.054 24 Aim: To determine the incidence of gestational diabetes mellitus at Federal Medical Centre, Abeokuta and to evaluate the feto-maternal outcome of their pregnancies. Materials and Methods: This study is a 5 year retrospective review of gestational diabetes mellitus cases at the Federal Medical Centre, Abeokuta (between 2009 to 2013) as well as the outcomes of these pregnancies. A proforma was used to collect data from case notes of all gestational diabetes mellitus (GDM) cases diagnosed within the stated period. All pregnant women in 24 weeks of gestation and above who are considered to be at risk after undergoing preliminary clinical examination were given a 75g oral glucose load, using the WHO standardized oral glucose tolerance test [4,5]. Gestational diabetes mellitus was diagnosed if 2 hour plasma glucose was ≥140 mg/dl. Results: The incidence rate of gestational diabetes mellitus was found to be 1.13% of the pregnancies. Overall, there was a preponderance of GDM mothers with tertiary level of education (34.15%). The majority of mothers with GDM in this study, had maternal age ≥31yrs (78.1%), increased body mass index ≥25 (82.9%) and previous intrauterine fetal death (28.3%). Many of the women (48.78%) had parity of 2-3 and various complications were seen in 43.9% of mothers and 22% of the newborns. Caesarean section as the mode of delivery was significantly high at 61%. Conclusion: The morbidities associated with gestational diabetes are still enormous and timely screening of mothers could be beneficial in reducing the complications seen in gestational diabetes mellitus mothers.

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Gestational Diabetes in a Tertiary Healthcare Centre at Abeokuta, South Western Nigeria: A Five Year Retrospective Review

E ciency of gestational diabetes mellitus screening and socio-demographics of pregnant subjects attending antenatal care

Background: Hypertensive disorders of pregnancy remain among the most significant causes of pregnancy-related complications. The research by the Dietary Approaches to Stop Hypertension (DASH) group revealed that non-pharmacological measures and intervention such as diet can be used to control blood pressure.

Objective: This study was completed to determine the frequency of consumption of local food among females who were pregnant and their relationship with pregnancy-related hypertensive disorders.

Methods: This was a descriptive research study of females who were pregnant with pre-eclampsia (PE) and gestational hypertension (GH) who presented at the Federal Medical Centre (FMC), Abeokuta, Nigeria. During the study period (September–October 2019) at the tertiary healthcare centre, 45 subjects who were pregnant were select from a PE and GH group, and matched with 45 patients with normotension. Comparison of bean meal onsumption (gbegiri) and bone meal (gbure-oloboro) consumption in subjects who were pregnant did not reveal statistically significant differences in those with PE and GH.

Results: The findings reveal a statistically significant difference in milk consumption between females who were pregnant with mild and severe PE (p=0.019). There was also a statistically significant difference in subjects with mild and severe GH who consumed milk (p=0.003).

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C. F. Chukwunyere

Papers

Gestational Diabetes in a Tertiary Healthcare Centre at Abeokuta, South Western Nigeria: A Five Year Retrospective Review

E ciency of gestational diabetes mellitus screening and socio-demographics of pregnant subjects attending antenatal care

A Comparative Study of Local Dietary Intake Among Subjects with Hypertensive Disorders of Pregnancy Attending Antenatal Care