Factors affecting perinatal morbidity and mortality in pregnancies complicated by diabetes mellitus in Sudan

Abstract

To investigate the influence of obstetric factors and indices of maternal metabolic control on perinatal morbidity and mortality, 88 diabetic pregnant Sudanese women (type 1, n=38; type 2, n=31; gestational diabetes, n=19) and 50 non-diabetic pregnant control women were studied. The mean fasting blood glucose was 11.1±2.8 mmol/l and the mean HbA 1c at booking interview was 8.8±2.1% in the diabetic women. Pregnancy complications such as Caesarean sections, urinary tract infections, pregnancy-induced hypertension and intrauterine foetal death were higher among diabetic compared with control women ( P<0.0001) and varied with the type of diabetes. Infants of diabetic mothers had a higher incidence of neonatal complications than those of non-diabetic women (54.4% vs. 20.0%; P<0.0001). Infants without complications and who were born to diabetic mothers had better Apgar scores at 5 min (9.8±0.5 vs. 8.9±1.6; P<0.01) and lower cord C-peptide when compared to infants with complications ( P<0.05). In conclusion, the prevalence of maternal and neonatal complications among Sudanese diabetic women and their infants is high. Maternal hyperglycaemia is an important factor affecting maternal wellbeing and neonatal morbidity and mortality.