Postpartum glycemia and pregnancy outcomes among women in Arusha Region, Tanzania

Abstract

Background: Gestational diabetes mellitus is a medical condition that disappears after delivery if early diagnosis and management are done. This study aimed to determine the prevalence of hyperglycemia six weeks postpartum and pregnancy outcomes among women in Arusha City.   Methods: A longitudinal study was conducted between March and December 2018 as part of a large study which involved 468 randomly selected pregnant women and excluded those who were diagnosed with diabetes before pregnancy. Women were screened for hyperglycemia six weeks postpartum where fasting and oral glucose tolerant tests were done by Gluco-Plus™ using World Health Organization criteria. Body fat percentage, mid-upper arm circumference, height and weight were measured using standard procedures. Postpartum information was collected using a structured questionnaire and data was analyzed using the Statistical Package for Social Science version 20 to obtain descriptive and inferential statistics. Results: Among 468 women who participated in the study at baseline, 392 (83.7%) returned for postpartum assessments. Postpartum hyperglycemia among women was 2.1% (n=8) and majority had normal delivery (92.6%, n=363) while 7.4% (n=29) delivered through caesarean section. About 8.2% (n=32) of the newborn were macrosomia and 4.1% (n=16) low birth weight. Miscarriages or abortions were not identified while stillbirth was observed in 0.5% (n=2) and neonatal death (1.3%, n=5). Postpartum hyperglycemia was significantly associated with body fat percentage (AOR 1.59, 95% CI: 1.14-1.91), mid-upper arm circumference (AOR 1.62, 95% CI: 1.023-1.99), macrosomia (AOR 2.43, 95% CI: 2.2-10.31) and family history of type 2 diabetes (AOR 6.4, 95% CI: 1.93-13.3). Conclusion: Prevalence of postpartum hyperglycemia was generally low however; it was significantly associated with macrosomia, increased body fat percentage, mid-upper circumference and family history of type 2 diabetes.  Also, a low prevalence of poor pregnancy outcomes was reported which may be attributed to actions taken after being referred for further treatments and management which need further exploration.