Effects of Level of Glycaemic Control in Reduction of Maternal and Perinatal Complications Among Pregnant Diabetic Women at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Abstract

Diabetes in pregnancy is associated with increased risk of morbidity for mother and fetus during pregnancy and at birth as well as later in life. The objective of this study was to determine the association between level of glycaemic control and maternal and perinantal complications in pregnant diabetic women. Institution based retrospective cross sectional study was conducted using 162 charts of women diagnosed with pregestational diabetes and gestational diabetes on follow ups at Endocrine and Metabolism Unit of Tikur Anbessa Specialized Hospital. Women diagnosed with type 1 diabetes mellitus (T1DM) were 76 (46.9%), types 2 diabetes were 38 (23.5%) and gestational diabetes were 48 (29.6%). Fifty five (34.0%) women had good fasting blood glucose (FBG), and 29 (17.9%) had good 2 hour post-prandial (2hPP) blood glucose according to international diabetes federation recommendation. Preeclampsia developed in 35 (21.6%) women. Cesarean section was done for 107 (66.0%) women and 55 (44.05%) had vaginal delivery. Still birth accounted for 26 (16.0%) of births and macrosomia occurred in 35 (21.6%) of births. Average FBG was significantly associated with preeclampsia [AOR (95% CI) = 3.36 (1.18, 9.60)]. Still birth of neonate was also significantly associated with average 2hPP blood glucose [AOR (95% CI) = 8.77 (1.07, 71.72)]. Neonatal weight was significantly associated with maternal age [AOR (95% CI) = 3.25 (1.30, 7.91)], average FBG [AOR (95% CI) = 7.39 (1.80, 30.26)] and average 2hPP blood glucose [AOR (95%CI) = 0.24 (0.67, 0.87)]. In conclusion, maternal blood glucose affects maternal and perinatal outcome while, maternal age affect only perinatal outcome.

Keywords: glycaemic control, pregestational diabetes, gestesional diabetes, maternal and perinantal complications, Tikur Anbessa Specialized Hospital, Ethiopia