Gestational glucose intolerance among pregnant women at the Cape Coast Teaching Hospital

Nelson Ekow Kumah; Evans Kofi Agbeno; Leonard Derkyi-Kwarteng; Ebenezer Aniakwaa-Bonsu; Sampson Kafui Djonor; Samuel Acquah

doi:10.1186/s12884-024-06568-y

Gestational glucose intolerance among pregnant women at the Cape Coast Teaching Hospital

BMC Pregnancy Childbirth. 2024 May 14;24(1):356. doi: 10.1186/s12884-024-06568-y.

Authors

Nelson Ekow Kumah¹, Evans Kofi Agbeno², Leonard Derkyi-Kwarteng³, Ebenezer Aniakwaa-Bonsu¹, Sampson Kafui Djonor⁴, Samuel Acquah⁵

Affiliations

¹ Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
² Department of Obstetrics and Gynaecology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
³ Department of Pathology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
⁴ Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.
⁵ Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana. sacquah@ucc.edu.gh.

Abstract

Background: Malaria in pregnancy can have adverse outcomes if untreated. Both malaria and pregnancy are associated with insulin resistance and diabetes. Although malaria is treated prophylactically with gestational diabetes mellitus (GDM) screened for in pregnancy as part a routine antenatal care, their impacts have not been examined in terms of other forms of dysglycaemia. This cross-sectional study examined insulin resistance and its relationship with dysglycaemia and malaria among pregnant women in the Cape Coast Teaching Hospital (CCTH).

Methods: Using a structured questionnaire, demographic and clinical information were obtained from 252 pregnant women aged 18-42 years. Weight and height were measured for computation of body mass index (BMI). Measurement of insulin, lipid profile and glucose were taken under fasting conditions followed by oral glucose tolerant test. Insulin resistance and beta-cell function were assessed by the homeostatic model as malaria was diagnosed by microscopy.

Results: The respective prevalence of GDM, gestational glucose intolerance (GGI) and insulin resistance were 0.8% (2/252), 19.44% (49/252) and 56.75% (143/252). No malaria parasite or dyslipidaemia was detected in any of the participants. Apart from BMI that increased across trimesters, no other measured parameter differed among the participants. Junior High School (JHS) education compared with no formal education increased the odds (AOR: 2.53; CI: 1.12-5.71; P = 0.03) but 2^nd trimester of pregnancy compared to the 1^st decreased the odds (AOR: 0.32; CI: 0.12-0.81; P = 0.02) of having insulin resistance in the entire sample. In a sub-group analysis across trimesters, pregnant women with JHS education in their 3^rd trimester had increased odds (AOR: 4.41; CI: 1.25-15.62; P = 0.02) of having insulin resistance.

Conclusion: Prevalence of GDM and GGI were 0.8% and 19.44% respectively. The odds of insulin resistance increased in pregnant women with JHS education in the 3^rd trimester. Appropriate measures are needed to assuage the diabetogenic risk posed by GGI in our setting.

Keywords: Gestational diabetes mellitus; Gestational glucose intolerance; Insulin resistance; Malaria; Pregnancy.

MeSH terms

Adolescent
Adult
Blood Glucose / analysis
Blood Glucose / metabolism
Body Mass Index
Cross-Sectional Studies
Diabetes, Gestational* / epidemiology
Educational Status
Female
Glucose Intolerance / blood
Glucose Intolerance / epidemiology
Glucose Tolerance Test
Hospitals, Teaching*
Humans
Insulin Resistance*
Malaria / blood
Malaria / epidemiology
Pregnancy
Pregnancy Complications, Parasitic / blood
Pregnancy Complications, Parasitic / epidemiology
Prevalence
South Africa / epidemiology
Young Adult