Gestational diabetes and intra uterine fetal death complication in a tertiary health facility

Abstract

Aim: To determine the prevalence of GDM and risk factors of IUFD and to determine the magnitude of IUFD complication in these women. Background: GDM is relatively common among antenatal population in Jos. There are several risk factors for GDM which includes family history in first degree relatives, obesity, advanced maternal age, glycosuria and selected adverse outcomes in previous pregnancy (for example still birth or macrosomia). Still birth occurs at gestational age greater than 24 weeks, late IUFD is between 20-23 weeks and abortion occurs in gestation of less than 20 weeks. Still birth is caused by maternal, fetal or placental conditions, and may be the result of the interaction between them. In Nigeria, the prevalence of diabetes in pregnancy (based on report from the South western parts of Nigeria) range from 0.06-0.25 percent. This study seeks to determine the prevalence of GDM in our antenatal populations and to determine the complications of pregnancies associated with GDM e.g. letal complication of IUFD. Materials and methods: This is a prospective cross-sectional study of five hundred and sixty pregnant GDM women with age range of 20-49 years with mean age of 28 years. This study was carried out between the months of June, 2017 to May, 2018. The weight of the subject was measured to the nearest kilogram with a Hanson type bathroom weighing scale. The height was measured to the nearest centimeter. The body mass index (BMI) was calculated and recorded. Determination of plasma glucose by the glucose oxidase method. 3 glucose values were obtained and diagnosis based on 2 or more falling at cut off values for GDM according to the criteria given by WHO, 1999. Sampling at 0hr ≥ 5.8mmol/L, 1hr ≥ 10.0mmol/L and 2hr ≥ 8.5mmol/L respectively for 100g of oral glucose load Result: The Data obtained was represented using Stata Software version 11. The various parameters include glucose levels, table showing GDM, IUFD, History of GDM, parity and age was shown. The prevalence of GDM is 4.3%. Gestational age of less than 20 weeks (abortion) is 15.1%, at gestational age of 20-23 (late IUFD) then at >23 weeks was found to be 76%. Prevalence of hypertension is 19.6% and 31.4% had positive history of T2DM Conclusion: GDM is relatively common among this antenatal population in Jos attending ANC Jos University Teaching Hospital (JUTH). It may be possible to prevent many maternal and fetal complications by strategies such as timely screening methods and managing blood glucose in afflicted pregnant women. There are two methods for screening; universal and selective methods recommended by America Diabetes Association. Advocacy for awareness of GDM prevalence and its complication is important.