Effect of diabetes mellitus on pregnancy and birth outcomes in Wolaita Zone, Southern Ethiopia: A retrospective cohort study

Diabetes Metab Syndr. 2022 Jan;16(1):102364. doi: 10.1016/j.dsx.2021.102364. Epub 2021 Dec 11.

Abstract

Background and aims: Presence of diabetes mellitus (DM) during pregnancy is important cause of maternal and fetal complications. Studies that address the effect of DM on pregnancy and birth outcome are scarce in Ethiopia. The aim of this study was to determine the effect of DM on maternal and birth outcomes in Wolaita Zone, Southern Ethiopia.

Methods: A retrospective cohort study was done to compare maternal and birth outcomes of mothers with DM and non-DM who received maternity service in three hospitals and four health centers in Southern Ethiopia. A total of 136 exposed (with DM) and 272 unexposed (non-DM) mothers were included in the study. Data were extracted from medical records of mothers by experienced and trained data collectors. Means were compared for continuous variables. Logistic regression analysis model was used to check the effect of DM on pregnancy and birth outcome. Risk Ratio was calculated and p value less than 0.05 was considered statistically significant.

Results: Pregnancy of diabetic mothers was significantly complicated by pre-eclampsia when compared with non-diabetic mothers, (RR = 1.8: 95% CI; 1.2-2.7). The risk of macrosomia was higher for neonates of diabetic mothers than non-diabetic mothers, (RR = 1.9: 95% CI; 1.3-2.7). From multivariate analysis, mothers with DM were 2.9 times more likely to be delivered by caesarean section than non-diabetic mothers (RR = 2.9: 95%CI; 1.3-6.2) and the risk of pre-term delivery was 2.5 times higher among mothers with DM, (RR = 2.5: 95% CI; 1.1-6.2).

Conclusions: Diabetes mellitus among pregnant mothers is associated with increased risk of pre-term delivery, macrosomia and maternal complications of pre-eclampsia and caesarian delivery. Early detection and management of DM should be one of the key activities to improve maternal and child mortality and morbidity.

Keywords: Birth outcome; Diabetes in pregnancy; Effect of diabetes; Southern Ethiopia.

MeSH terms

  • Cesarean Section*
  • Child
  • Diabetes, Gestational* / epidemiology
  • Ethiopia / epidemiology
  • Female
  • Fetal Macrosomia / epidemiology
  • Fetal Macrosomia / etiology
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Retrospective Studies