Foeto-maternal outcome of diabetes in a tertiary health facility in Nigeria
Author(s): C O John, J O Alegbeleye, and A O Otoide

Diabetes complicating pregnancy is associated with adverse maternal, foetal and neonatal outcomes. We have determined the prevalence of both pre-gestational (PGDM) and gestational diabetes mellitus (GDM), and their associated maternal and perinatal morbidities and mortalities at the University of Port-Harcourt Teaching Hospital, Nigeria. A retrospective study was carried out of all cases of diabetes in pregnancy between 2008 and 2012. The case notes of the next two non-diabetic patients, whose gestational ages and parities matched, were examined as case controls. There were 122 cases of diabetes from a total of 14, 521 deliveries (8.4 per 1000 deliveries), 21 cases of PGDM, and 101 cases of GDM (1.45 per 1000 deliveries and 6.96 per 1000 deliveries respectively). There were 60 cases of foetal macrosomia (49%). The mean birth weight was 3.75±0.76 kg. There were 11 perinatal deaths (perinatal mortality rate 90 per 1000 deliveries). The caesarean delivery rate was 89%. Sixty (60) babies (49%) required neonatal intensive care admission. There were no maternal deaths or congenitally malformed babies. We conclude that diabetes in pregnancy is associated with adverse maternal and neonatal outcomes. Patients at risk should be encouraged to attend preconception clinics and register early in well-equipped hospitals for antenatal care. Universal screening of all pregnant women at booking and patients with clinical risks characteristics at 24 and 28 weeks of gestation may be effective for the early identification and management of GDM.


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