TITLE:
Association among Cases of Pregnancy Weight Gain, Gestational Diabetes Mellitus and Neonatal Delivery Outcomes at Mama Lucy Kibaki Hospital, Nairobi City
AUTHORS:
Gabriel Muswali, Rosebella Onyango, Bernard Guyah, Walter Otieno
KEYWORDS:
Excessive GWG, GDM, Neonatal Deliveries, Macrosomia and Preterm Births
JOURNAL NAME:
Open Access Library Journal,
Vol.10 No.2,
February
20,
2023
ABSTRACT: Background: Gestational Weight Gain and Gestational Diabetes Mellitus are interrelated and are also closely associated with adverse neonatal deliveries namely macrosomia and preterm births. However, available literature does not shed light on comparison between the magnitude of adverse newborn outcomes associated with GDM and GWG together on one hand and GWG only on the other hand in women of various BMI in Kenya. Consequently, this study investigated the association among the cases of GWG, GDM and neonatal outcomes in women of various BMI attending antennal care and eventually delivering at Mama Lucy Kibaki Hospital in Nairobi, Kenya. Method: This panel longitudinal study was undertaken from January to July, 2019 and it involved prospective tracking of gestational weight gain, gestational diabetes mellitus and the associated neonatal deliveries (macrosomia and preterm births) in 337 pregnant women of various BMIs. The women in their fifth gestational month were recruited into the project at Mama Lucy Kibaki Hospital during the antenatal visit and followed up to the delivery stage. During the follow up and delivery stage, data on gestational weight gain and details of the delivery were collected. Two sets of data were collected; one set of women with excessive GWG, GDM and associated neonatal deliveries and another set (of women) with neonatal outcomes but without excessive GWG and GDM. The data were analyzed through bivariate logistic regression which involved determining crude and adjusted odds of neonatal births (macrosomia and preterm) births occurring in the presence and absence of excessive GWG and GDM in women of various BMIs. Results: There was no association among cases of excessive GWG in women of underweight (AOR = 3.326; 95% CI: 0.519 - 21.318; p = 0.205) and normal weight (AOR = 0.470; 95% CI: 0.150 - 1.467; p = 0.194) BMI on one and neonatal deliveries on the other hand. However, there was significant relationship among cases of excessive GWG in women with overweight (AOR = 0.192; 95% CI: 0.074 - 0.500; p = 0.001) and obese BMI (AOR = 0.501; 95% CI: 0.267 - 0.939; p = 0.031) on one hand and neonatal deliveries on the other hand. Excessive GWG and GDM are good predictors of adverse neonatal outcomes in overweight and obese women and not in women of underweight and normal BMI.