Quality of glycemic control and pregnancy outcomes among patients with gestational diabetes at the Kenyatta National Hospital, Kenya
DOI:
https://doi.org/10.59692/jogeca.v33i4.461Keywords:
gestational diabetes, insulin, macrosomia, stillbirths, preterm birthsAbstract
Background: The prevalence of diabetes and gestational diabetes is rising worldwide. If poorly managed, diabetes in pregnancy has a far-reaching negative impact on the mother and newborn.
Objective: To determine the quality of glycemic control and pregnancy outcomes among patients with gestational diabetes in Kenyatta National Hospital, Nairobi, Kenya.
Methods: A retrospective descriptive cohort study design was employed. The study setting was Kenyatta National Hospital, Nairobi, Kenya. The study population was women with diabetes in pregnancy. The study period was May 2011 to November 2019. A sample size of 258 diabetic pregnant patients was reached; 230 and 28 were in the exposed and unexposed groups with the average third trimester fasting blood sugar levels of ≥5.3mmol/L and <5.3mmol/L, respectively. Data were analyzed using the IBM statistical package for social sciences (SPSS) version 23. A p-value of <0.05 was considered statistically significant.
Results: The prevalence of poor glycemic control (average third-trimester fasting blood sugar level ≥5.3mmol/L) was 89.1 . There was a higher % incidence of macrosomia (25.7 vs. 21.4 ; p-value % % 0.627), stillbirths (17.9 vs. 3.6 ; p-value 0.058) % % and preterm birth (43.9 vs. 21.4 ; p-value 0.025) % % among patients with gestational diabetes with poor glycemic control compared to those with good glycemic control. Among mothers with poor glycemic control, the pre-existing diabetes patients experienced significantly worse outcomes of stillbirths (20.9 vs. % 0 ; p-value 0.004) and preterm births (47.2 vs. % % 24.2 ; p-value 0.014) than the gestational diabetes % patients.
Conclusion: Poorly controlled diabetes in pregnancy increases the risk of adverse pregnancy outcomes,
including macrosomia, stillbirths, and preterm births, with the poorly controlled pre-existing diabetic women experiencing significantly worse outcomes of stillbirths and preterm births than the poorly controlled gestational diabetes patients.
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