Gestational Diabetes Mellitus Is a Risk for Macrosomia: Case- Control Study in Eastern Ethiopia

Background - Gestational diabetes mellitus is any degree of glucose intolerance at onset or first recognition during pregnancy. A pregnant woman with diabetes and her unborn child are at increased risk of pregnancy complications and adverse neonatal outcomes. The aim of this study was to assess the association of gestational diabetes mellitus and adverse birth outcomes among women who gave birth in Eastern Ethiopia. Method – Unmatched case control study design was conducted in Hiwot Fana Specialized University Hospital and Dilchora Hospital from December 2015 to April 2017. This study involved a total of 1,834 mothers and their babies. A structured and pre-tested questionnaire was used to collect the socio-demographic data. Mothers who had risk factor for gestational diabetes were screened by oral glucose tolerance tests. Adverse birth outcomes were observed and registered after delivery. Multivariate logistic regression analysis was employed to identify predictors of adverse birth outcome. P value less than 0.05 was considered to decide statistical significance. Results: From a total of 1,834 mothers 47 (2.6%) of them were found to have gestational diabetes. In binary logistic regression analysis macrosomia and still were found to have an association with gestational diabetes, COR=11[95% CI = 5.7-21.2] and COR= 2.9[95% CI = 1.02-8.5] respectively. Macrosomia was independently associated with GDM and babies born to mothers with gestational diabetes. Babies born from mothers with gestational diabetes were 8.5 times more likely to have macrosomia than babies born to non-diabetic mothers, AOR = 8.5 [95% CI = 5.7-21.4]. Conclusion: This study revealed that only macrosomia was strongly associated with gestational diabetes and this finding is coherent with studies done at different parts of the world. Early screening and treatment of mothers with GDM can minimize the adverse birth outcomes, therefore routine screening service for pregnant women who are at risk of developing gestational diabetes must exist at all health facilities in Ethiopia.