The Association of Overweight and Obesity with Gestational Diabetes Mellitus in Pregnant Women Attending Ante Natal Care in Selected Hospital in Addis Ababa, Ethiopia, 2019/2020
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Date
2021-06
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Addis Abeba University
Abstract
Background: Gestational Diabetes Mellitus (GDM) is associated with a higher incidence of
maternal, perinatal, and neonatal morbidities. Publication around the world showed that
overweight and /obesity is a potential risk factor for gestational diabetes mellitus. Because of
late antenatal care booking in our country and self-report of pre-pregnancy body mass index
is not reliable, it’s difficult to get pre-pregnancy or early pregnancy body mass index to
measure overweight and obesity. Despite the increment in the incidence of overweight and
obesity in our country, there is limited study showing the association of overweight and
obesity with GDM in pregnant women and even the available studies lack consistency in
findings.
Objective: This study aims to assess the association of maternal overweight and obesity with
gestational diabetes mellitus in pregnant women in selected hospitals of Addis Ababa from
March 10 to July 30, 2020.
Methods: An unmatched case-control study was conducted on 159 pregnant women with
GDM (case) and 477 pregnant women without GDM (control) in selected hospitals in Addis
Ababa. Each hospital had been conducted screening of GDM for high-risk pregnant women
and diagnosis was made using the 2013 World Health Organization (WHO) criteria by a
physician. Overweight and obesity were measured using Mid-Upper Arm Circumference
(MUAC) and Calf Circumference (CC). Descriptive statistics used to present the sociodemographic
profile of the study participants. Binary and multiple logistic regression
analyses were done to measure the association of overweight and obesity with GDM. Finding
was reported using adjusted odds ratios with 95% confidence interval and statistical
difference was declared at P-value <0.05.
Result: GDM was associated with obesity (MUAC ≥33 and CC ≥39 cm) (AOR = 2.80; 95%
CI: 1.58–4.90) but not with overweight (MUAC ≥ 28 cm) (AOR = 1.51; 95% CI: 0.71–3.21).
Previous history of caesarean section (AOR = 1.91; 95% CI: 1.14–3.21), having inadequate
minimum dietary diversification score (<5) (AOR = 3.55; 95% CI: 2.15–5.86), engaging in
low and moderate physical activity (AOR = 3.56; 95% CI: 1.49–8.48) and (AOR = 1.99; 95%
CI 1.17–3.40) also associated with the development of GDM.
Conclusion and Recommendation: Obesity but not overweight have found to be
significantly associated with the development of GDM. Thus, screening for GDM is
recommended for obese pregnant women (having MUAC ≥33 and CC ≥39 cm). Policy
makers also should plan policies to decrease obesity among women of childbearing age
before and in between conception. Antenatal care providers should provide information for
women of childbearing age on maintaining a healthy body weight before and in between
pregnancies, the need for healthy diversified food and physical activity.
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Keywords
Gestational Diabetes mellitus, obesity, overweight, MUAC, CC