Gestational Diabetes Mellitus and Feto-Maternal Outcomes in Federal Medical Centre, Yenagoa, Bayelsa State-A Comparative Study of Two Diagnostic Criteria.

Abstract

Background: The prevalence of gestational diabetes mellitus (GDM) is dependent on the diagnostic criteria used and there is no consensus on screening methods and diagnostic criteria. The International Association for Diabetes in Pregnancy Study Group (IADPSG) recently put forward new diagnostic criteria and encourages its adoption worldwide. The aim of this study was to determine the incidence of GDM and to compare the foeto-maternal outcomes of women diagnosed with GDM in the Federal Medical Centre, Yenagoa using the WHO 1999 and IADPSG criteria.

Methodology: This was a cohort study of 340 women who were booked for antenatal care at the Federal Medical Centre, Yenagoa. Women who gave consent to participate in this study took part in a 75-gram, 2-hour oral glucose tolerance test (OGTT). The diagnosis of GDM was sought in each participant using both the WHO 1999 and the IADPSG criteria. The incidence and the foeto-maternal outcomes in women diagnosed with GDM using different criteria were compared.

Results: The incidence of GDM was 5.3% in the IADPSG (case) group and 3.8% in the WHO (control) group. This difference was not statistically significant (p = 0.18). There was no significant difference between the groups for foetal and maternal outcomes that were assessed. Maternal outcomes were pre-eclampsia (p = 0.48), polyhydramnios (p = 0.31), insulin therapy (p = 0.35), caesarean section (p = 0.28), genital tract laceration (p = 0.18) and instrumental vaginal delivery (p = 0.34). Foetal outcomes were birth weight ≥ 4kg (p = 0.07), neonatal jaundice (p = 0.38), hypoglycaemia (p = 0.46), birth injuries (p = 0.42) and shoulder dystocia (p = 0.23).

Conclusion: The application of the IADPSG criteria in our environment may lead to an increase in the number of women being managed for GDM without any appreciable improvement in foetal and maternal outcomes.