Prevalence, predictors and challenges of gestational diabetes mellitus screening among pregnant women in northern Tanzania

Trop Med Int Health. 2018 Feb;23(2):236-242. doi: 10.1111/tmi.13018. Epub 2017 Dec 13.

Abstract

Objectives: To determine the prevalence and predictors of gestational diabetes mellitus (GDM) as well as acceptability of returning for glucose tolerance testing among pregnant women in Moshi municipality, northern Tanzania.

Methods: Cross-sectional study from October 2015 to April 2016 among women with gestation age of 24-28 weeks of pregnancy attending at Kilimanjaro Christian Medical Centre (KCMC) referral hospital, Majengo and Pasua Health Centres. Women were interviewed and requested to return the next day (window within a month, depending on gestational age) for fasting plasma glucose (FPG) testing, followed immediately by a 75 g oral glucose tolerance test (OGTT). GDM was diagnosed using the 2013 WHO criteria. Logistic regression was conducted to reveal independent predictors for GDM.

Results: Of 433 interviewed women, 100 (23%) did not return for FPG and OGTT testing. The prevalence of GDM among the 333 screened women was 19.5%, and 3% had diabetes in pregnancy (DIP). GDM was significantly associated with age ≥35 years (adjusted OR 6.75), pre-pregnancy obesity (AOR 2.22) and history of abortion (AOR 2.36).

Conclusion: Prevalence of GDM is high in Moshi. We recommend introduction of routine screening for hyperglycaemia during pregnancy along with strategies for follow-up to prevent long-term effects of GDM and DIP in women and their children.

Keywords: DSG; GDM; Tanzania; Tanzanie; diabetes in pregnancy; diabète gestationnel; diabète pendant la grossesse; diabète sucré gestationnel; gestational diabetes; gestational diabetes mellitus; hyperglycaemia in pregnancy; hyperglycémie pendant la grossesse; predictors; prédicteurs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Cross-Sectional Studies
  • Diabetes, Gestational / diagnosis*
  • Diabetes, Gestational / epidemiology*
  • Female
  • Glucose Tolerance Test / statistics & numerical data*
  • Humans
  • Mass Screening / organization & administration*
  • Pregnancy
  • Prenatal Care / organization & administration*
  • Prevalence
  • Risk Factors
  • Tanzania
  • Young Adult

Substances

  • Blood Glucose