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 3383 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. Binomial regression and generalized estimating equations 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, -1.57; 95% CI, -2.51 to -0.62; P=0.001), and fetal loss (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.

Keywords: Africa; Gestational hyperglycemia; Gestational hypertension; Low birth weight; Preterm birth; Stillbirth.