PREVALENCE AND OUTCOME OF PREGESTATIONAL DIABETES MELLITUS AMONG PREGNANT MOTHERS ATTENDING ANTENATAL CARE AT THREE TEACHING HOSPITALS IN ADDIS ABABA, PROSPECTIVE FOLLOW UP STUDY

Abstract

ABSTRACT
BACkGROUND: Diabetes mellitus is one of the most common medical conditions complicating pregnancy with a significant impact on maternal and perinatal outcome.
OBJECTIVE: To assess the prevalence of pregestational diabetes mellitus and its pregnancy outcome at three teaching hospitals in Addis Ababa METHODS: Prospective cohort study was conducted at three teaching government hospitals in Addis Ababa, Ethiopia. RESULT: There were a total of 19,797 deliveries, among which 80 were women with pregestational diabetes mellitus were identified making a prevalence of 0.4%. Out of these 39(48.8%) had type 1 and 41(51.2%) had type 2 diabetes mellitus. The glycemic control was poor in each trimester with higher fasting, 2-hour post prandial and HgA1C level than the standard. Majority of pregnancies (67.1%) ended up with induction of labor for fetal and maternal indications and 61.8% were delivered by cesarean section. Hypertensive disorders of pregnancy were commonest maternal complication seen in 28.5% of the women. The rate of premature delivery and neonatal intensive care referral was high (53.4%). There was statistically significant association between adverse pregnancy outcome and having preconception care. care. CONCLUSION: The Prevalence of pregestational diabetes mellitus was found to be comparable to most setups. The glycemic control was poor in each trimester with higher fasting, 2-hour post prandial and HgA1C level from the standard. These hospitals should have management protocol advocating preconceptional care and tighter glucose control which may help in reducing the adverse maternal and perinatal outcome. kEY WORDS: Pregestational diabetes mellitus; Pregnancy outcome, prevalence (Ethiopian Journal of Reproductive Health; 2019; 11;1:9-18