Nshimiyumuremyi Emmanuel, Nigatu Balkachew Kabtyimer, Amberbir Alemayehu, J Gilson George, Manzi Subira, Nkubito Valens, Gashema Heritier, Gibia Sandrine, Temesgen Fikremelekot, Sitini Bertin, Mugaba Michael, Byiringiro Jean Paul
Department of Obstetrics and Gynecology, Kigali University Teaching Hospital, Kigali, Rwanda
Department of Obstetrics and Gynecology, King Faisal Hospital, Kigali, Rwanda.
BMJ Open. 2025 Aug 31;15(8):e098248. doi: 10.1136/bmjopen-2024-098248.
The study aimed to evaluate the cumulative incidence of gestational diabetes (GD) among pregnant women receiving antenatal care at the King Faisal Hospital (KFH) in Kigali, Rwanda, using the criteria established by the International Association of Diabetes and Pregnancy Study Groups and endorsed by the WHO in 2013.
Prospective cohort study.
KFH-Kigali, Rwanda.
A total of 284 pregnant women were enrolled between May 2023 and April 2024.
The cumulative incidence rate of GD was 19.5% (95% CI 15% to 24.6%). Most participants (78%) were from Kigali City. Most participants belong to high-income households (96.5%) and were employed (85%). Risk factors associated with the development of GD included increased body mass index (adjusted relative risk (aRR) 3.2; 95% CI 2.02 to 5.3), a history of macrosomia (aRR 4.9; 95% CI 1.6 to 12) and family history of type 2 diabetes (aRR 4.6; 95% CI 1.3 to 14). Women diagnosed with GD had a significantly higher risk of adverse outcomes, including pre-eclampsia and gestational hypertension (aRR 6.7; 95% CI 1.7 to 26) polyhydramnios (aRR 6.4; 95% CI 1.94 to 8.9), postpartum haemorrhage (aRR 3; 95% CI 2.7 to 3.9) and caesarean delivery (aRR 4.9; 95% CI 1.6 to 9.1). Neonatal complications were also common in infants born to mothers with GD, including neonatal hypoglycaemia (aRR 2.2; 95% CI 1.2 to 4.5), neonatal intensive care unit admission (aRR 1.7; 95% CI 1 to 4.6) and macrosomia (aRR 2.3; 95% CI 1.01 to 3.5).
This study provides important data on the cumulative incidence of GD at the KFH in Rwanda and highlights the key maternal and neonatal factors and adverse outcomes associated with the condition. Given the growing global burden of obesity and diabetes, further research and public health education are essential for mitigating the double burden of GD on maternal and neonatal health.
本研究旨在采用国际糖尿病与妊娠研究组制定并于2013年得到世界卫生组织认可的标准，评估卢旺达基加利法赛尔国王医院（KFH）接受产前护理的孕妇中妊娠期糖尿病（GD）的累积发病率。
前瞻性队列研究。
卢旺达基加利的KFH。
2023年5月至2024年4月期间共招募了284名孕妇。
GD的累积发病率为19.5%（95%置信区间15%至24.6%）。大多数参与者（78%）来自基加利市。大多数参与者属于高收入家庭（96.5%）且有工作（85%）。与GD发生相关的危险因素包括体重指数增加（调整后相对风险（aRR）3.2；95%置信区间2.02至5.3）、巨大儿病史（aRR 4.9；95%置信区间1.6至12）和2型糖尿病家族史（aRR 4.6；95%置信区间1.3至14）。被诊断为GD的女性出现不良结局的风险显著更高，包括子痫前期和妊娠期高血压（aRR 6.7；95%置信区间1.7至26）、羊水过多（aRR 6.4；95%置信区间1.94至8.9）、产后出血（aRR 3；95%置信区间2.7至3.9）和剖宫产（aRR 4.9；95%置信区间1.6至9.1）。新生儿并发症在患有GD的母亲所生婴儿中也很常见，包括新生儿低血糖（aRR 2.2；95%置信区间1.2至4.5）、新生儿重症监护病房收治（aRR 1.7；95%置信区间1至4.6）和巨大儿（aRR 2.3；95%置信区间1.01至3.5）。
本研究提供了关于卢旺达KFH中GD累积发病率的重要数据，并突出了与该疾病相关的关键母婴因素及不良结局。鉴于全球肥胖和糖尿病负担日益加重，进一步的研究和公共卫生教育对于减轻GD对母婴健康的双重负担至关重要。
