Glucose intolerance and associated factors among antenatal clients at Kenyatta National hospital at 24-36 weeks
Abstract
The prevalence of glucose intolerance worldwide has been on the increase with the
highest incidence being among non-industrialized nations. Data on trends especially
in pregnancy and associated risk factors in Kenya is lacking. There is evidence that
antepartum screening and early intervention prevents future complications and
improves maternal-fetal outcome making it essential to screen at risk mothers during
pregnancy. The data from this study will provide the current prevalence rates and
guidance on clinical circumstances for which screening will be benef cial.
Objective:
To determine the prevalence of, and associated factors for glucose intolerance
among antenatal clients at Kenyatta National Hospital between 24-36 weeks of
pregnancy.
Study site:
Kenyatta National Hospital antenatal clinic: Nairobi; Kenya
Study design:
Cross-sectional analytical study.
Materials and methods:
One hundred and two antenatal mothers at a gestational age of 24-36 weeks
underwent a 100g OGTT between November 15th 2008 and April 15th 2009 after
consenting to participate in the study. Their socio-demographic data, obstetric/
gynecologic history and familial history was obtained through an interviewer
administered questionnaire. The results were interpreted according to the Carpenter
and Couston/ American Diabetic Association Criteria and entered in a results sheet.
These were then analyzed using SPSS version 15.
Results
From one hundred and two participants, 37(36%) had glucose intolerance while 65
(64%) had normal glucose tolerance. Among clients with glucose intolerance, 16.7%
met the diagnostic criteria for gestational diabetes, 3.9% had impaired glucose
tolerance while 15.7% had impaired fasting glycaemia. 22.5% of clients with normal
glucose tolerance displayed flat curves.
Factors significantly associated with glucose intolerance were: BMI 2: 25; P value
0.036: OR 0.37 (1.06-6.90), history of and treatment for infertility P value 0.002: OR
9
8.69(1.74-43.50) and family history of hypertension; P value 0.037: OR 2.66(1.04-
6.78).
Conclusion
The prevalence of glucose intolerance was 36 %. The factors associated with glucose
intolerance were body mass index 2: 25, family history of hypertension and history of
infertility.
Recommendations
1. Screening - all antenatal mothers should be screened for glucose intolerance
regardless of risk status as part of the antenatal profile.
2. Advocacy-there is need to raise awareness about the diabetic epidemic, its public
health implications and the need for screening and intervention to reduce
complications.