The Burden and Risk Factors of Hyperglycaemia in Pregnancy in Uganda: A Cross-Sectional Study

Abstract

Aims: Hyperglycaemia in pregnancy (HIP) is a major determinant of maternal and offspring adverse outcomes, but there are little data from sub-Saharan Africa. This study examined the burden and risk factors of HIP in Uganda. Materials and Methods: We collected data sociodemographic, anthropometric and clinical data from approximately 4000 pregnant women attending antenatal clinics in Uganda. Oral glucose tolerance test performed at 24-28 weeks gestation to screen for hyperglycaemia. Prevalence was defined as the number of participants diagnosed with HIP as a proportion of the total number of participants enrolled into the study, during the study period. Univariable and multivariable Poisson regression models were fitted to calculate prevalence ratios for association between risk factors and the outcome. Results: Using the 2013 WHO criteria, 8.5% (95% CI: 7.7-9.4%) of the women had HIP. In multivariable analyses, older maternal age (>30 years) and mid-gestation obesity were the key factors associated with hyperglyceamia; other factors, such as HIV infection, were less important. Conclusions: This study reveals a high prevalence of HIP in Uganda, with obesity an important contributor. Cost-effective interventions are urgently needed to mitigate this major health threat in Africa, where the rates of obesity are increasing.