Antenatal Management and Maternal/fetal Outcomes associated with hyperglycaemia in pregnancy (HIP) in Uganda: A prospective cohort study

dc.contributor.authorNakabuye, Betty
dc.contributor.authorSekitoleko, Isaac
dc.contributor.authorMubiru, Michael
dc.contributor.authorTumwesigire, Samuel
dc.contributor.authorTino, Salome
dc.contributor.authorMirembe, Sandy
dc.contributor.authorKakande, Ayoub
dc.contributor.authorAgaba, Brian
dc.contributor.authorNansubuga, Faridah
dc.contributor.authorZaake, Daniel
dc.contributor.authorAyiko, Ben
dc.contributor.authorKalema, Herbert
dc.contributor.authorNakubulwa, Sarah
dc.contributor.authorSekikubo, Musa
dc.contributor.authorNakimuli, Annettee
dc.contributor.authorWebb, Emily L.
dc.contributor.authorNyirenda, Moffat J.
dc.contributor.authorMilln, Jack
dc.contributor.authorNatamba, Barnabas Kahiira
dc.date.accessioned2021-10-04T13:41:16Z
dc.date.available2021-10-04T13:41:16Z
dc.date.issued2021-05-19
dc.description.abstractBackground: Hyperglycaemia in pregnancy (HIP) is associated with complications for both mother and baby. The prevalence of the condition is likely to increase across Africa as the continent undergoes a rapid demographic transition. However, little is known about the management and pregnancy outcomes associated with HIP in the region, particularly less severe forms of hyperglycaemia. It is therefore important to generate local data so that resources may be distributed effectively. The aim of this study was to describe the antenatal management and maternal/fetal outcomes associated with HIP in Ugandan women. Methods: A prospective cohort study of 2917 pregnant women in five major hospitals in urban/semi-urban central Uganda. Women were screened with oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. Cases of gestational diabetes (GDM) and diabetes in pregnancy (DIP) were identified (WHO 2013 diagnostic criteria) and received standard care. Data was collected on maternal demographics, anthropometrics, antenatal management, umbilical cord c-peptide levels, and pregnancy outcomes. Results: Two hundred and seventy-six women were diagnosed with HIP (237 classified as GDM and 39 DIP). Women had between one and four fasting capillary blood glucose checks during third trimester. All received lifestyle advice, one quarter (69/276) received metformin therapy, and one woman received insulin. HIP was associated with large birthweight (unadjusted relative risk 1.30, 95% CI 1.00–1.68), Caesarean delivery (RR 1.34, 95% CI 1.14–1.57) and neonatal hypoglycaemia (RR 4.37, 95% CI 1.36–14.1), but not perinatal mortality or preterm birth. Pregnancy outcomes were generally worse for women with DIP compared with GDM. Conclusion: HIP is associated with significant adverse pregnancy outcomes in this population, particularly overt diabetes in pregnancy. However pregnancy outcomes in women with milder forms of hyperglycaemia are similar to those with normoglycaemic pregnancies. Intervention strategies are required to improve current monitoring and management practice, and more research needed to understand if this is a cost-effective way of preventing poor perinatal outcomes.en_US
dc.identifier.citationMilln, J., Nakabuye, B., Natamba, B.K., Sekitoleko, I., Mubiru, M., Namara, A.A., Tumwesigire, S., Tino, S., Mirembe, M., Kakande, A. and Agaba, B., 2021. Antenatal management and maternal/fetal outcomes associated with hyperglycaemia in pregnancy (HIP) in Uganda; a prospective cohort study. BMC pregnancy and childbirth, 21(1), pp.1-9.en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12280/2839
dc.language.isoenen_US
dc.publisherBMCen_US
dc.titleAntenatal Management and Maternal/fetal Outcomes associated with hyperglycaemia in pregnancy (HIP) in Uganda: A prospective cohort studyen_US
dc.typeArticleen_US

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