Screening for Gestational Diabetes Mellitus: Findings from a Resource Limited Setting of Nigeria

Abstract

Diabetes is a growing non communicable disease (NCD) epidemic. Current international guidelines dictate that in pregnancy, universal screening for GDM for early detection is essential to improve feto-maternal outcomes. However in resource limited settings, risk based screening is still in practice. We undertook records-based review of 837 women who accessed antenatal care between November 2014 and October 2015. The aim was to evaluate the pattern of screening and clinical outcomes of GDM in a resource limited setting of the Niger Delta region of Nigeria. Only 3.7% of the study population representing 31 women was screened for GDM, giving the overall prevalence of GDM among study participants as 3.3% (28 women). A comparison of fetomaternal outcomes between women screened for GDM and those not screened for GDM showed comparable proportions for gestational age at delivery, mode of delivery and fetal outcome relating to hypoglycaemia, respiratory distress and neonatal jaundice. Also, a significantly higher proportion of babies born to mothers who were screened for GDM were admitted into the Special Care Baby Unit (SCBU). There was no significant difference between the prevalence of stillbirths, neonatal jaundice, hypoglycaemia and respiratory distress in babies born to women diagnosed with GDM compared with babies born to women not screened for GDM. Selective risk based screening for GDM may be leading to missed cases of GDM. The need for universal screening is hereby reiterated.