The Case for Early and Universal Screening for Gestational Diabetes Mellitus: Findings from 9314 Pregnant Women in a Major City in Nigeria

Diabetes Ther. 2022 Oct;13(10):1769-1778. doi: 10.1007/s13300-022-01307-y. Epub 2022 Aug 25.

Abstract

Introduction: Risk-based screening has been replaced by universal screening as the recommended course of care for gestational diabetes mellitus (GDM). As of 2016, no state in Nigeria had implemented a policy of universal screening for GDM. This research aimed to assess findings from a universal screening programme and its implication for scaling up universal and early screening for GDM.

Methods: This was a descriptive cross-sectional study conducted in Rivers State Nigeria between February 2017 and January 2020. Multistage sampling was used to recruit 9314 pregnant women from 30 primary, secondary, and tertiary health facilities in the state. An interviewer-administered structured questionnaire was used by trained healthcare workers to collect socio-demographic, obstetric and medical information. All study participants had a plasma glucose test on their first hospital visit and a diagnosis made using the World Health Organization (WHO) criteria. Data obtained was analysed using the IBM Statistical Package for Social Sciences (SPSS) version 23.

Results: Most women [5683 (61.0%)] were aged 25-34 (mean 29.60 ± 5.64) years. The prevalence of GDM in this study was 5.2% with a prevalence of GDM in the first, second and third trimesters of 4.9%, 4.2% and 6.7%, respectively. The prevalence of GDM among persons with a family history of diabetes was 13.2% (97 persons) while 4.6% (391 persons) without family history were diagnosed with GDM. Gestational age, family history of diabetes and age group were found to be significant predictors of GDM among the study participants after adjusting for confounding variables.

Conclusion: The practice of universal screening was useful in identifying GDM in 1 out of 20 pregnant women in the study sample. Screening at all trimesters was useful in identifying GDM. There is an urgent need to scale up early and universal screening for GDM across sub-Saharan Africa.

Keywords: Gestational diabetes mellitus; Pregnancy; Universal screening.