Maternal hyperglycemia and adverse pregnancy outcomes in Dar es Salaam, Tanzania

Abstract

Objective To evaluate maternal glucose levels during pregnancy as a predictor of adverse perinatal outcomes in Dar es Salaam, Tanzania. Methods Random blood glucose measurements were analyzed from 3833 pregnant women enrolled in a randomized trial to assess the impact of multivitamins on pregnancy outcomes in Dar es Salaam between August 2001 and July 2004. Information on maternal and neonatal morbidity was recorded at monthly study visits, delivery, and 6 weeks postpartum. Generalized estimating equations specified with a binomial distribution and log-link function were used to determine the relationship between elevated glucose (>7.8 mmol/L) and pregnancy outcomes. Results In total, 25 women had elevated glucose (0.7%). Hyperglycemia was associated with an increased risk of delivery before 37 weeks [relative risk (RR), 2.11; 95% confidence interval [CI], 1.07–4.13; P=0.03), delivery before 34 weeks (RR, 4.15; 95% CI, 1.43–12.03, P=0.009), incident gestational hypertension (RR, 2.90; 95% CI, 1.24–6.76; P=0.01), low birth weight (RR, 2.87; 95% CI, 1.18–6.99; P=0.02), reduced newborn head circumference (mean difference, –1.53; 95% CI, –2.51 to –0.62; P=0.001), and stillbirth (RR, 3.38; 95% CI, 1.13–10.08; P=0.03). Conclusion Maternal hyperglycemia is uncommon among pregnant Tanzanian women, but nonetheless seems to increase the risk of several adverse perinatal outcomes.

Maternal Pre-conception Body Mass Index and Fasting Plasma Glucose With the Risk of Pre-term Birth: A Cohort Study Including 4.9 Million Chinese Women

“…Hyperglycemia has been suggested to be associated with increased risk of pregnancy complications and adverse prenatal outcomes ( 11 , 26 ). Billionnet et al found that the risk of PTB was 5.8 and 3.1 times higher in type 1 diabetes and type 2 diabetes, separately, than in the no diabetes group ( 11 ).…”

Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study

“…APO is a complex, multifactorial, physiological outcome in women, and despite decades of research, a clear causal mechanism for APOs has not been established. Studies have reported numerous risk factors for APOs such as malaria [ 6 ], infection [ 7 – 12 ], anaemia [ 13 – 16 ], obesity [ 17 ], hypertension [ 18 ], hyperglycaemia [ 19 ], diabetes [ 20 ], periodontal disease [ 21 ], endometriosis [ 22 ], history of abortion [ 23 ], antenatal complications [ 24 ], antenatal care (ANC) [ 24 ], environmental pollution [ 25 – 29 ], violence [ 30 ], and other socio-economic disparities [ 31 – 33 ]. In many low- and middle-income countries, access to improved sanitation facilities is limited, but the link between sanitation and APOs has not been explored.…”

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

“…Also, this low prevalence of poor pregnancy outcomes may be due to the referrals that enabled women to have further checkups and treatments hence, reduced poor pregnancy outcomes. A study done in Dar es Salaam, Tanzania supports these findings that treatment reduces the risk of pregnancy complications hence; hyperglycemic women may have an increased risk of morbidities among women and their newborns (Darling et al, 2014).…”