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Adverse Maternal Outcomes of Fijian Women with Gestational Diabetes Mellitus and the Associated Risk Factors

Reproductive Sciences volume 27, pages 2029–2037 (2020)Cite this article

Abstract

The purpose of this study is to determine the factors associated with adverse maternal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) in urban Fiji. This cross-sectional study used data from existing records of singleton pregnant women with GDM attending the Colonial War Memorial Hospital (CWMH) Suva Fiji between June 2013 and May 2014. Data retrieved included demographic data, antenatal and intrapartum care data, route of delivery, treatment modality, and maternal risk factors. The prevalence of GDM is 3.0%, n = 255/8698, and the most frequent maternal complications were induction of labor (66%), C-section (32%), and preeclampsia (19%), and 25% had babies with birthweight > 4 kg. Older women (≥ 36 years) and those treated with insulin were 5.2 times and 10.7 times, respectively, more likely to have labor induction during childbirth compared with younger women and those on dietary management. Family history of diabetes was associated with 2.4× and/or 2.5× higher odds of cesarean delivery and/or develop hypertension in pregnancy, respectively. Parity > 5 children and diagnoses of GDM after the first trimester reduced the odds of cesarean delivery. The odds of developing preeclampsia in GDM was 3.4 times higher (95% confidence interval (CI) of adjusted odds ratio (aOR): 1.03, 18.78) among obese women than normal-weight women, and married women were less likely to have babies with birthweight > 4 kg. The prevalence of and adverse outcomes among women with GDM attending antenatal public health care in Suva Fiji were higher than previously reported from the hospital. Older and multiparous women with GDM, those insulin treated, and with a strong family history and high body mass index (BMI) need special attention and better monitoring by health care personnel to reduce adverse outcomes during pregnancy.

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Fig. 1

Availability of Data

Data for this study is stored on the hospital database and can be made available on request from the first author.

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Acknowledgments

The authors are grateful to the following persons for their help during data collection: James Fong, Nola Mahe, Ilisapeci Kubuabola, Drs Julia Singh, Amanda Noovao, Pushpa Nusair, Litia Narube, Swaran Naidu, Dr. Viliame Nasila, Dr. Vasiti Cati, and Professor Rajat Gyaneshwar.

Author information

Affiliations

  1. Diabetes, Obesity and Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW, 2560, Australia

    Uchechukwu L. Osuagwu & David Simmons

  2. Ministry of Health, Vaoila Hospital, Tongatapu, Tonga

    Falahola Fuka

  3. School of Science and Health, Western Sydney University, Campbelltown, NSW, 2560, Australia

    Kingsley Agho

  4. African Vision Research Institute, University of KwaZulu-Natal Durban, Durban, South Africa

    Kingsley Agho

  5. Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar

    Adnan Khan

  6. Department of Medicine, Weill Cornell Medicine, New York, NY, USA

    Adnan Khan

Authors
  1. Uchechukwu L. Osuagwu
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  2. Falahola Fuka
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  3. Kingsley Agho
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  4. Adnan Khan
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  5. David Simmons
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Contributions

UL Osuagwu: Protocol/project development, data management, data analysis, manuscript writing

F Falahola: Protocol/project development, data collection or management

A Khan: Protocol/project development, manuscript writing

K Agho: Data analysis, manuscript writing/editing

D Simmons: Protocol/project development, manuscript editing

Corresponding author

Correspondence to Uchechukwu L. Osuagwu.

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I certify on behalf of myself and all co-authors that all authors have read and approved the manuscript, and there are no financial disclosures or conflict of interest of any sort. The protocol for the research conforms to the provisions of the Declaration of Helsinki in 1995 (as revised in Edinburgh 2000) and was approved by Research Ethics Committee of the College of Medical Nursing and Health Sciences of the Fiji National University and by the Fiji National Health Research Ethics Review Committees (ref #: 2015.48.CEN).

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The authors declare no conflict of interest.

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The submitted work is an original retrospective study and not under consideration for publication in any other journal.

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Osuagwu, U.L., Fuka, F., Agho, K. et al. Adverse Maternal Outcomes of Fijian Women with Gestational Diabetes Mellitus and the Associated Risk Factors. Reprod. Sci. 27, 2029–2037 (2020). https://doi.org/10.1007/s43032-020-00222-6

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  • DOI: https://doi.org/10.1007/s43032-020-00222-6

Keywords

  • Birthweight
  • Cesarean section
  • Diabetes
  • Fiji
  • Gestational diabetes
  • Prevalence