Anne Marie Darling1, Enju Liu2, Said Aboud3, Willy Urassa3, Donna Spiegelman4, Wafaie Fawzi5. 1. Department of Global Health and Population, Harvard School of Public Health, Boston, USA. Electronic address: adarling@hsph.harvard.edu. 2. Department of Global Health and Population, Harvard School of Public Health, Boston, USA. 3. Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 4. Department of Epidemiology, Harvard School of Public Health, Boston, USA; Department of Biostatistics, Harvard School of Public Health, Boston, USA. 5. Department of Global Health and Population, Harvard School of Public Health, Boston, USA; Department of Epidemiology, Harvard School of Public Health, Boston, USA; Department of Nutrition, Harvard School of Public Health, Boston, USA.
Abstract
OBJECTIVE: To evaluate maternal glucose levels during pregnancy as a predictor of adverse perinatal outcomes in Dar es Salaam, Tanzania. METHODS: Random blood glucose measurements were analyzed from 3383 pregnant women enrolled in a randomized trial to assess the impact of multivitamins on pregnancy outcomes in Dar es Salaam between August 2001 and July 2004. Information on maternal and neonatal morbidity was recorded at monthly study visits, delivery, and 6 weeks postpartum. Binomial regression and generalized estimating equations were used to determine the relationship between elevated glucose (>7.8 mmol/L) and pregnancy outcomes. RESULTS: In total, 25 women had elevated glucose (0.7%). Hyperglycemia was associated with an increased risk of delivery before 37 weeks [relative risk (RR), 2.11; 95% confidence interval [CI], 1.07-4.13; P=0.03), delivery before 34 weeks (RR, 4.15; 95% CI, 1.43-12.03, P=0.009), incident gestational hypertension (RR, 2.90; 95% CI, 1.24-6.76; P=0.01), low birth weight (RR, 2.87; 95% CI, 1.18-6.99; P=0.02), reduced newborn head circumference (mean difference, -1.57; 95% CI, -2.51 to -0.62; P=0.001), and fetal loss (RR, 3.38; 95% CI, 1.13-10.08; P=0.03). CONCLUSION: Maternal hyperglycemia is uncommon among pregnant Tanzanian women, but nonetheless seems to increase the risk of several adverse perinatal outcomes.
OBJECTIVE: To evaluate maternal glucose levels during pregnancy as a predictor of adverse perinatal outcomes in Dar es Salaam, Tanzania. METHODS: Random blood glucose measurements were analyzed from 3383 pregnant women enrolled in a randomized trial to assess the impact of multivitamins on pregnancy outcomes in Dar es Salaam between August 2001 and July 2004. Information on maternal and neonatal morbidity was recorded at monthly study visits, delivery, and 6 weeks postpartum. Binomial regression and generalized estimating equations were used to determine the relationship between elevated glucose (>7.8 mmol/L) and pregnancy outcomes. RESULTS: In total, 25 women had elevated glucose (0.7%). Hyperglycemia was associated with an increased risk of delivery before 37 weeks [relative risk (RR), 2.11; 95% confidence interval [CI], 1.07-4.13; P=0.03), delivery before 34 weeks (RR, 4.15; 95% CI, 1.43-12.03, P=0.009), incident gestational hypertension (RR, 2.90; 95% CI, 1.24-6.76; P=0.01), low birth weight (RR, 2.87; 95% CI, 1.18-6.99; P=0.02), reduced newborn head circumference (mean difference, -1.57; 95% CI, -2.51 to -0.62; P=0.001), and fetal loss (RR, 3.38; 95% CI, 1.13-10.08; P=0.03). CONCLUSION:Maternal hyperglycemia is uncommon among pregnant Tanzanian women, but nonetheless seems to increase the risk of several adverse perinatal outcomes.
Authors: Siri Vangen; Camilla Stoltenberg; Synne Holan; Narve Moe; Per Magnus; Jennifer R Harris; Babill Stray-Pedersen Journal: Diabetes Care Date: 2003-02 Impact factor: 19.112
Authors: Bijaya K Padhi; Kelly K Baker; Ambarish Dutta; Oliver Cumming; Matthew C Freeman; Radhanatha Satpathy; Bhabani S Das; Pinaki Panigrahi Journal: PLoS Med Date: 2015-07-07 Impact factor: 11.069