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喀麦隆林贝市三家医疗机构就诊孕妇群体中妊娠期糖尿病的患病率及危险因素:一项横断面研究

Prevalence and risk factors of gestational diabetes mellitus in a population of pregnant women attending three health facilities in Limbe, Cameroon: a cross-sectional study.

作者信息

Egbe Thomas Obinchemti, Tsaku Elvis Songa, Tchounzou Robert, Ngowe Marcelin Ngowe

机构信息

Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Buea, Cameroon.

CMA Sonjkolong, Adamawa Region, Cameroon.

出版信息

Pan Afr Med J. 2018 Nov 20;31:195. doi: 10.11604/pamj.2018.31.195.17177. eCollection 2018.

Abstract

INTRODUCTION

There are few studies regarding gestational diabetes mellitus (GDM) in the South West Region of Cameroon. We aimed at determining the prevalence and risk factors of GDM in three health facilities in the Limbe health district, Cameroon.

METHODS

A cross-sectional study was carried out in one secondary, and two primary healthcare facilities in Limbe, Cameroon during the period 1 November 2016 to 31 January 2017. We administered a pretested questionnaire on 200 consenting pregnant women at 24-28 weeks' gestation. We carried out a 2-hr oral glucose tolerance test after fasting overnight. GDM was diagnosed when ≥1 plasma glucose (PG) test result was abnormal according to the IADPSG criteria (FPG ≥92 mg/dL, PG 1-hr 180mg/L, PG 2-hr 153 mg/dL). Data analysis was with Epi-Info version 3.5.4. Associations were analyzed with the Pearson's chi squared and Fischer's exact test where appropriate. Statistical significance was set at p < 0.05.

RESULTS

The prevalence of GDM was 20.5% and respondents' mean age was 27.8 (SD 5.7) years. Majority, 13.5% participants had abnormal FPG alone, while 3.5% had any two abnormal values. GDM was associated with: advanced maternal age (OR 3.4: 95% CI 1.7-7.0; P<0.001), BMI≥30 kg/m (OR 6.2 : 95% CI 2.9-13.1, P<0.001), past history of unexplained stillbirth (OR 5.7: 95% CI 2.5-12.9, P<0.001) and history of macrosomia (OR 8.5:95% CI 3.8-19, P<0.001).

CONCLUSION

With the high prevalence of GDM, identification of its associated factors has the potential to be a target of intervention to prevent poor obstetrical outcomes.

摘要

引言

喀麦隆西南部地区关于妊娠期糖尿病(GDM)的研究较少。我们旨在确定喀麦隆林贝卫生区三家医疗机构中GDM的患病率及危险因素。

方法

于2016年11月1日至2017年1月31日期间,在喀麦隆林贝的一家二级医疗机构和两家初级医疗机构开展了一项横断面研究。我们对200名孕周在24 - 28周且同意参与的孕妇进行了一份预先测试的问卷调查。在禁食过夜后,进行了2小时口服葡萄糖耐量试验。根据国际糖尿病与妊娠研究组(IADPSG)标准(空腹血糖(FPG)≥92mg/dL,1小时血糖180mg/L,2小时血糖153mg/dL),当≥1次血糖(PG)检测结果异常时,诊断为GDM。数据分析采用Epi-Info 3.5.4版本。在适当情况下,使用Pearson卡方检验和Fisher精确检验分析关联。设定统计学显著性为p < 0.05。

结果

GDM的患病率为20.5%,受访者的平均年龄为27.8(标准差5.7)岁。大多数(13.5%)参与者仅FPG异常,而3.5%有任意两项异常值。GDM与以下因素相关:高龄产妇(比值比(OR)3.4:95%置信区间(CI)1.7 - 7.0;P < 0.001)、体重指数(BMI)≥30kg/m²(OR 6.2:95% CI 2.9 - 13.1,P < 0.001)、既往不明原因死胎史(OR 5.7:95% CI 2.5 - 12.9,P < 0.001)和巨大儿史(OR 8.5:95% CI 3.8 - 19,P < 0.001)。

结论

鉴于GDM的高患病率确定其相关因素有可能成为预防不良产科结局的干预目标。

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