Effect of maternal alcohol consumption on gestational diabetes detection and mother-infant’s outcomes in Kinshasa, DR Congo

Abstract

Objectives: Since it has been suggested that moderate alcohol drinking would increase insulin sensitivity, which could benefit Gestational Diabetes Mellitus (GDM), the study aimed at evaluating alcohol consumption during pregnancy, and seeing whether this consumption influences GDM detection and maternal/perinatal outcomes. Study design: Women with already known diabetes and those with multiple pregnancy were excluded. All other pregnant women attending antenatal care unit of the university clinics, Kinshasa, DR Congo during the period from 1 March throughout 31 October 2010, were invited at 24-week gestation to enroll in O'Sullivan blood glucose testing and if eligible in 100-gram oral glucose tolerance test. Alcohol consumption, risk factors for GDM, and general characteristics such as age, parity, gestity, BMI, fat mass were registered. Diagnosed GDM was first treated with diet and exercise, thereafter with Metformin, and if necessary with insulin. For other (normal) women data remained blinded until confinement. Maternal and infant's adverse outcomes such as maternal urinary infection, preeclampsia, cesarean section, intrauterine growth retardation, birth weight < 2500 g, birth weight ≥ 3800 g (as stated > percentile 90 in our milieu), Apgar score at the first minute < 7, shoulder dystocia or other birth injury, neonatal hypoglycemia and fetal alcohol syndrome (FAS) were compared and analyzed according to GDM diagnosis as well to alcohol status. Results: Up to 240 pregnant women accepted to enroll into the study. Alcohol consumption concerned 78 (32.5%) of the women, most of them (61 = 25.42%) being heavy consumers. Risk factors for GDM and Physical and blood glucose characteristics were alike (p not significant) in both consumers and non consumers, except for history of HTA in the family that was significantly more frequent (p = 0.02) among drinkers. GDM's prevalence was 9%. No adverse outcome was more prominent in any subgroup, except Apgar score < 7 at the first minute that was more frequent (p = 0.038) among neonates of GDM mothers. No FAS, neither shoulder dystocia nor neonatal hypoglycemia were diagnosed. When alcohol status was considered, Birthweight ≥ 3800 g was found more frequent (p = 0.0284) in alcohol consumers than in abstainers. Risk of this outcome was three times higher when history of family hypertension was present (odds ratio 2.694; CI: 0.536 -13.544). Conclusions: The prevalence of alcohol consumption by pregnant women of our series (32.5%) seems not to impact the detection of GDM (9%). FAS was not diagnosed. Lack of significant differences in adverse outcomes between GDM and non GDM could be attributed to huge follow-up of GDM women. Influence of alcohol consumption on birth weight mostly in setting of familial history of hypertension remains to be addressed.

Actual and predicted prevalence of alcohol consumption during pregnancy in the WHO African Region

“…The prevalence of alcohol consumption during pregnancy among the general population in the 25 identified studies ranged from 2.5% (Nigeria) to 32.5% (Democratic Republic of the Congo) (Table ). Five studies reported the prevalence of binge drinking during pregnancy among the general population, which ranged from 3.8% (South Africa) to 25.4% (Democratic Republic of the Congo) (Table ).…”

Socioeconomic and lifestyle factors associated with HPV infection in pregnant women: a matched case-control study in Beijing, China

“…The percent of women consuming alcohol during pregnancy has been reported as a serious problem in other countries, such as 32.5% in Congo [ 31 ], 4.4% in India [ 32 ]. A study in Korea [ 33 ] suggests that women who drink alcohol may have an increased risk of persistent HPV.…”

Proteomic-driven biomarker discovery in gestational diabetes mellitus: A review

“…The present day lifestyle, which primarily includes carbohydrate rich diet leading to obesity, is considered to be one of the major causes of this disease. Risk factors including maternal lifestyle, pre-pregnancy body mass index (BMI) [6], advancing age [7], abdominal circumference, smoking [8], alcohol consumption [9], history of Polycystic Ovarian Syndrome (PCOS) [10], use of anti-psychotics [11], exposure to air pollutants [12] and perfluorochemicals [13] during pregnancy are known to contribute towards disease progression. GDM complicates pregnancy by affecting both neonatal growth and maternal health.…”