Pregnancy outcome of patients with Diabetes at University of Maiduguri Teaching Hospital: a 5-year retrospective review

Abstract

Background: Diabetes Mellitus (DM) is a common medical disorder that complicates about 16% of pregnancies worldwide. DM may result in significant adverse maternal and fetal outcomes, if not recognised early and properly managed. Objective: To determine the prevalence, perinatal, and maternal outcomes of Diabetes in pregnancy at the University of Maiduguri Teaching Hospital, Nigeria. Methodology: A 5-year retrospective review of women with Diabetes Mellitus in pregnancy carrying a singleton pregnancy managed at the Obstetrics and Gynaecology department of the University of Maiduguri Teaching Hospital, Nigeria. Data was analysed using SPSS version 25 and presented in tables and figures. P-value < 0.05 was considered statistically significant. Results: A total of 16,390 deliveries were recorded during the period under review out of which 176 women had DM in pregnancy, giving a prevalence of 1.1%. Gestational Diabetes Mellitus (GDM) has a prevalence of 0.7% (accounting for 74.83% of  cases). The risk factors for DM in pregnancy were found to be GDM in a previous pregnancy, family history of DM,  booking weight greater than 90 kg, or BMI greater than 30k g/m . Significantly, women with GDM are more likely to be controlled by diet and exercise only compared to women with Pre-Gestational Diabetes Mellitus (PGDM); P=0.004. The overall risk of preterm delivery was 4.2%, and preterm delivery was significantly higher in PGDM compared to the GDM group (P=0.048). Although not statistically significant, C-section rate (66.7% vs 52.3%), Preeclampsia (5.6% vs 4.75%), congenital anomaly (2.8% vs 1.9%), neonatal SCBU admission (25.0% vs 14.0%), recurrent UTI (2.8% vs 0%), and development of hypoglycaemia (5.6% vs 0.9%) were more common among patients with PGDM compare to those with GDM. While fetal macrosomia, (28.0% vs. 19.4%), shoulder dystocia (3.7% vs 0%), and IUFD(3.7% vs. 2.8%) were commoner in the GDM group compared to the PGDM group; however, the rate of ENND was the same among both groups. Conclusion: The prevalence of DM in pregnancy in
this study is low and patients with GDM were more likely to be controlled with dietary therapy compared to patients with PGDM. Preterm delivery is commoner in patients with PGDM.