Hyperglycemia in pregnancy diagnosed using glycated hemoglobin (HbA1c) in Uganda: a preliminary cross-sectional report [version 1; peer review: 1 approved]
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Emerald Open Research
Abstract
Hyperglycemia in pregnancy (HIP) is a common medical
complication during pregnancy and is associated with several short
and long-term maternal-fetal consequences. We aimed to determine
the prevalence and factors associated with HIP among Ugandan
women.
Methods: We consecutively enrolled eligible pregnant women
attending antenatal care at Kawempe National Referral Hospital,
Kampala, Uganda in September 2020. Mothers known to be living with
diabetes mellitus or haemoglobinopathies and those with anemia
(hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and
glycated hemoglobin A1c (HbA1c) were measured on peripheral
venous blood samples. HIP was defined as an HbA1c ≥5.7% with its
subsets of diabetes in pregnancy (DIP) and prediabetes defined as
HbA1c of ≥6.5% and 5.7-6.4% respectively. ROC curve analysis was
performed to determine the optimum cutoff of RBS to screen for HIP.
Results: A total of 224 mothers with a mean (± SD) age 26±5 years
were enrolled, most of whom were in the 2nd or 3rd trimester (94.6%,
n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of 6HIP was 11.2% (n=25) (95% CI: 7.7-16.0). Among the mothers with HIP,
2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP
were older (28 years vs. 26 years, p=0.027), had previous tuberculosis
(TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip
circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p = 0.032). However
only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI:
1.2-14.0; p=0.022). Using HbA1c as a reference variable, we derived an
optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a
sensitivity and specificity of 90.7% and 56.4% (area under the curve =
0.75 (95% CI: 0.70-0.80, p<0.001)), respectively.
Conclusions: HIP is common among young Ugandan women, the
majority of whom are without identifiable risk factors.
Description
Keywords
Hyperglycemia in pregnancy, Prediabetes, Hemoglobin A1c
Citation
Bongomin, F., Kyazze, A. P., Ninsiima, S., Olum, R., Nattabi, G., Nabakka, W., ... & Andia-Biraro, I. (2020). Hyperglycemia in pregnancy diagnosed using glycated hemoglobin (HbA 1c) in Uganda: a preliminary cross-sectional report. Emerald Open Research, 2(70), 70. https://doi.org/10.35241/emeraldopenres.14014.1