Obstetrical and perinatal outcomes among diabetic mothers delivered at Kigali University Teaching Hospital (CHUK)

Abstract

Diabetes adversely affects women and their babies during pregnancy, labor, and delivery. Miscarriage, cesarean sections (C/S), birth trauma, pregnancy induced hypertension (PIH), , obstructed labor, and so forth are among the effects of diabetes on maternal outcomes of pregnancy while macrosomia, congenital anomalies, birth injury, hypoglycemia, intrauterine fetal death (IUFD), stillbirth, shoulder dystocia, respiratory distress syndrome (RDS), polycythemia, and hyperbilirubinemia and so forth are perinatal and neonatal morbidities. Aim: To evaluate the obstetrical and perinatal outcomes among diabetic mothers delivered at CHUK in order to assess the magnitude of burden played by diabetes mellitus during the peri-partum period. Methods: A retrospective cross-sectional study conducted at CHUK which is a tertiary-level hospital located in Kigali city. Data were analyzed using Stata version 13. Logistic regression analysis was used to study the differences in maternal and neonatal outcomes among diabetic and non-diabetic mothers. Results: A significant difference was observed in having polyhydramnios among diabetic and nondiabetic patients where all six patients (11.54%) who were diagnosed with polyhydramnios were diabetic patients (p=0.012). Diabetic patients were more likely to have PIH (21.15% vs 1.92%), (p=0.012), to give birth to macrosomia babies (19.23% vs 3.85%), (p=0.014) compared to nondiabetic mothers. Hypoglycemia and stillbirth were more likely observed among diabetic mothers. Babies born from diabetic mothers had more neonatal jaundice (25.00%) compared to babies from non-diabetic mothers (9.62%) with a statistically significant difference (p=0.038). Mothers who were aged >35 years were 2.6 times more likely to have maternal complication compared to those who are aged less than 35 years (OR=2.55; 95% CI: 1.01-8.21; p=0.043). Conclusion: The study identified pregnancy induced hypertension (21.15%) and polyhydramnios (11.54%) as adverse maternal outcomes among diabetic mothers while macrosomia (19.23%), hypoglycemia (26.92%), jaundice (25.00%) and stillbirths (9.62%) were identified as adverse fetal outcomes among diabetes mothers delivering at CHUK. Diabetes mother who were aged >35 years were 2.9 times more likely to have maternal complication as those who are aged less than 35 years. Therefore we recommend enhancing counselling of pregnant diabetic mothers on diabetes mellitus control to prevent maternal and fetal complications and to enhance education of the general population on lifestyle changes in preventing diabetes.