Introduction
Subjects and methods
Setting
Data sources
Sample size
Outcome variables
Potential cofounding factors
Statistical analysis
Ethics
Results
Characteristics of Fijian women with GDM
Study characteristics | n = 255 | % |
---|---|---|
Maternal sociodemographic characteristics | ||
Age (years) | 30.7 ± 5.5 | |
18–25 | 46 | 18.0 |
26–35 | 160 | 62.8 |
≥ 36 | 49 | 19.2 |
Race/ethnicity | ||
Others§ | 22 | 8.6 |
Itaukei Fijians | 126 | 49.4 |
FIDs | 107 | 42.0 |
Educational levelǂ | ||
Non-tertiary (primary/secondary) | 157 | 62.8 |
Tertiary (university/polytechnic) | 93 | 37.2 |
Marital status | ||
Not married | 30 | 11.8 |
Married | 225 | 88.2 |
Gravidity (number of pregnancies) | ||
Primigravid (first pregnancy) | 34 | 13.3 |
Multiparous (2/more children) | 177 | 69.4 |
Grand multiparous (≥5 children) | 44 | 17.3 |
Maternal risk factors (yes, no) | ||
Family history of diabetes | ||
Yes | 128 | 50.2 |
No | 127 | 49.8 |
Previous history of GDM | ||
Yes | 11 | 4.3 |
No | 244 | 95.7 |
Previous baby > 4 kg | ||
Yes | 55 | 21.6 |
No | 200 | 78.4 |
Previous stillbirth | ||
Yes | 11 | 4.3 |
No | 244 | 95.7 |
Previous neonatal death | ||
Yes | 10 | 3.9 |
No | 245 | 96.1 |
Maternal BMI (kg/m2)ǂ | 33.2 ± 7.5 | |
Underweight/normal (< 25) | 35 | 14.9 |
Overweight (25–29.9) | 40 | 17.0 |
Obese (classes 1–3, ≥30.0) | 160 | 68.1 |
Antenatal factors (weeks) | ||
Gestational age at booking | 18.9 ± 7.5 | |
1st trimester (0–13) | 79 | 31.0 |
2nd trimester (14–27) | 134 | 52.6 |
3rd trimester (≥28) | 42 | 16.5 |
Gestational age at GDM diagnosis | 25.6 ± 7.8 | |
1st trimester (0–13) | 26 | 10.2 |
2nd trimester (14–27) | 111 | 43.5 |
3rd trimester (≥27) | 118 | 46.3 |
Gestational age at delivery | 38.3 ± 2.2 | |
< 37 | 44 | 17.2 |
37–41 | 211 | 82.8 |
Maternal post-pregnancy factors | ||
Mode of delivery | ||
Vaginal delivery | 173 | 67.8 |
Caesarean section | 82 | 32.2 |
Induced labour | ||
Yes | 98 | 38.4 |
No | 157 | 61.6 |
Preeclampsia | ||
Yes | 48 | 18.8 |
No | 207 | 81.2 |
Polyhydramnios | ||
Yes | 2 | 0.8 |
No | 253 | 99.2 |
Infectionǂ | ||
Yes | 3 | 1.2 |
No | 251 | 98.8 |
Factors associated with macrosomia among Fijian women with GDM
Variables | Prevalence of macrosomia (%) | OR | 95% CI | AOR | 95% CI |
---|---|---|---|---|---|
Maternal sociodemographic characteristic | |||||
Age (years) | |||||
18–25 | 17.4 | 1.00 | 1.00 | ||
26–35 | 25.0 | 1.58 | 0.68, 3.68 | 1.27 | 0.44, 3.72 |
≥ 36+ | 22.5 | 1.38 | 0.50, 3.80 | 0.70 | 0.17, 2.89 |
Race/ethnicity | |||||
Others§ | 31.8 | 1.00 | 1.00 | ||
Itaukei Fijians | 31.0 | 0.96 | 0.95 | 0.29, 3.12 | |
FIDs | 12.2 | 0.30 | 0.10,0.80* | 0.50 | 0.12, 2.02 |
Educational level | |||||
Non-tertiary (primary/secondary) | 24.2 | 1.00 | 1.00 | ||
Tertiary (university/polytechnic) | 21.5 | 0.86 | 0.46, 1.59 | 0.64 | 0.29, 1.42 |
Marital status | |||||
Not married | 40.0 | 1.00 | 1.00 | ||
Married | 20.9 | 0.40 | 0.16, 0.88* | 0.29 | 0.11, 0.77* |
Gravidity (number of pregnancies) | |||||
Primigravid (first pregnancy) | 11.8 | 1.00 | 1.00 | ||
Multiparous (2/more children) | 23.7 | 2.33 | 0.78, 7.00 | 1.17 | 0.30, 4.63 |
Grand multiparous (≥5 children) | 29.6 | 3.15 | 0.92, 10.74 | 0.85 | 0.15, 4.69 |
Maternal risk factors (Yes/No) | |||||
Family history of diabetes | |||||
No | 28.4 | 1.00 | 1.00 | ||
Yes | 17.8 | 0.55 | 0.31, 1.00 | 0.69 | 0.31, 1.54 |
Previous history of GDM | |||||
No | 23.4 | 1.00 | 1.00 | ||
Yes | 18.2 | 0.73 | 0.15, 3.47 | 3.68 | 0.58, 23.40 |
Previous baby > 4 kg | |||||
No | 15.5 | 1.00 | 1.00 | ||
Yes | 50.9 | 5.65 | 2.94, 10.86* | 6.08 | 2.46, 15.01* |
Previous stillbirth | |||||
No | 23.4 | 1.00 | 1.00 | ||
Yes | 18.2 | 0.73 | 0.15, 3.47 | 0.51 | 0.07, 3.70 |
Previous neonatal death | |||||
No | 22.9 | 1.00 | 1.00 | ||
Yes | 30.0 | 1.45 | 0.36, 5.78 | 2.92 | 0.46, 18.72 |
Maternal BMI (kg/m2) | |||||
Underweight / normal) | 17.1 | 1.00 | 1.00 | ||
Overweight | 15.0 | 0.85 | 0.25, 2.93 | 0.93 | 0.21, 4.12 |
Obese (classes 1–3, ≥30.0) | 26.3 | 1.72 | 0.67, 4.43 | 1.11 | 0.33, 3.71 |
Antenatal factors | |||||
Booking age of gestation (weeks) | |||||
1st trimester (0–13) | 12.7 | 1.00 | 1.00 | ||
2nd trimester (14–27) | 26.9 | 2.53 | 1.18, 5.45* | 1.59 | 0.60, 4.25 |
3rd trimester (≥28) | 31.0 | 3.09 | 1.22, 7.85* | 0.67 | 0.18, 2.57 |
Gestational age at GDM diagnosis (weeks) | |||||
1st trimester (0–13) | 3.9 | 1.00 | 1.00 | ||
2nd trimester (14–27) | 21.6 | 6.90 | 0.89, 53.53 | 3.44 | 0.34, 34.81 |
3rd trimester (≥27) | 28.8 | 10.12 | 1.32, 77.67* | 4.30 | 0.41, 45.30 |
Gestational age at delivery (weeks) | |||||
< 37 | 9.1 | 1.00 | 1.00 | ||
37–41 | 26.1 | 3.53 | 1.21, 10.31* | 2.72 | 0.75, 9.86 |
Maternal post-pregnancy factors | |||||
Delivery intervention | |||||
Induced labour | |||||
No | 23.3 | 1.00 | 1.00 | ||
Yes | 23.1 | 0.99 | 0.18, 0.50 | 1.37 | 0.13, 14.30 |
Caesarean section | |||||
No | 24.3 | 1.00 | 1.00 | ||
Yes | 20.5 | 0.80 | 0.42, 1.54 | 1.16 | 0.55, 3.49 |
Preeclampsia | |||||
No | 23.2 | 1.00 | 1.00 | ||
Yes | 22.9 | 0.98 | 0.47, 2.08 | 1.13 | 0.43, 3.02 |
Factors associated with neonatal hypoglycaemia among Fijian women with GDM
Variables | Prevalence of hypoglycaemia (%) | OR | 95% CI | AOR | 95% CI |
---|---|---|---|---|---|
Maternal sociodemographic factors | |||||
Age (years) | |||||
18–25 | 21.7 | 1.00 | 1.00 | ||
26–35 | 22.6 | 1.05 | 0.48, 2.33 | 0.82 | 0.32, 2.14 |
≥ 36 | 34.7 | 1.91 | 0.77, 4.77 | 1.31 | 0.40, 4.35 |
Race/ethnicity | |||||
Others§ | 31.8 | 1.00 | 1.00 | ||
Itaukei Fijians | 26.2 | 0.76 | 0.29, 2.03 | 0.97 | 0.30, 3.13 |
FIDs | 21.7 | 0.59 | 0.22, 1.63 | 0.95 | 0.26, 3.47 |
Educational level | |||||
Non-tertiary (primary/secondary) | 26.9 | 1.00 | 1.00 | ||
Tertiary (university/polytechnic) | 21.5 | 0.74 | 0.41, 1.37 | 0.76 | 0.37, 1.56 |
Marital status | |||||
Not married | 27.6 | 1.00 | 1.00 | ||
Married | 24.4 | 0.85 | 0.36, 2.03 | 0.72 | 0.26, 1.97 |
Gravidity (number of pregnancies) | |||||
Primigravid (first pregnancy) | 11.8 | 1.00 | 1.00 | ||
Multiparous (2/more children) | 27.3 | 2.81 | 0.94, 8.40 | 2.42 | 0.67, 8.73 |
Grand multiparous (≥5 children) | 25.0 | 2.50 | 0.72, 8.70 | 1.46 | 0.29, 7.42 |
Maternal risk factors (yes, no) | |||||
Family history of diabetes | |||||
No | 26.8 | 1.00 | 1.00 | ||
Yes | 22.8 | 0.81 | 0.46, 1.43 | 0.95 | 0.47, 1.95 |
Previous history of GDM | |||||
No | 24.3 | 1.00 | 1.00 | ||
Yes | 36.4 | 1.78 | 0.50, 6.30 | 0.83 | 0.16, 4.39 |
Previous baby > 4 kg | |||||
No | 22.6 | 1.00 | 1.00 | ||
Yes | 32.7 | 1.66 | 0.87, 3.20 | 1.19 | 0.51, 2.76 |
Previous stillbirth | |||||
No | 24.7 | 1.00 | 1.00 | ||
Yes | 27.3 | 1.14 | 0.29, 4.45 | 1.42 | 0.27, 7.45 |
Previous neonatal death | |||||
No | 24.2 | 1.00 | 1.00 | ||
Yes | 40.0 | 2.09 | 0.57, 7.66 | 3.96 | 0.79, 19.90 |
Maternal BMI (kg/m2) | |||||
Underweight/normal (< 25) | 8.8 | 1.00 | 1.00 | ||
Overweight (25–29.9) | 32.5 | 4.98 | 1.28, 19.33* | 5.49 | 1.01, 29.96* |
Obese (classes 1–3, ≥30.0) | 27.5 | 3.92 | 1.14, 13.48* | 4.34 | 0.87, 21.65 |
Antenatal factors | |||||
Booking age of gestation (weeks) | |||||
1st trimester (0–13) | 24.1 | 1.00 | 1.00 | ||
2nd trimester (14–27) | 25.6 | 1.08 | 0.57, 2.07 | 1.72 | 0.68, 4.34 |
3rd trimester (≥28) | 23.8 | 0.99 | 0.41, 2.37 | 1.09 | 0.30, 3.95 |
Age of gestation at GDM diagnosis (weeks) | |||||
1st trimester (0–13) | 38.5 | 1.00 | 1.00 | ||
2nd trimester (14–27) | 21.6 | 0.44 | 0.18, 1.10 | 0.40 | 0.10, 1.52 |
3rd trimester (≥27) | 24.8 | 0.53 | 0.22, 1.29 | 0.53 | 0.13, 2.17 |
Age of gestation at delivery (weeks) | |||||
< 37 | 39.5 | 1.00 | 1.00 | ||
37–41 | 21.8 | 0.43 | 0.21, 0.85* | 0.38 | 0.17, 0.89* |
Maternal post-pregnancy factors | |||||
Delivery intervention | |||||
Induced labour | |||||
No | 23.3 | 1.00 | 1.00 | ||
Yes | 25.6 | 1.14 | 0.62, 2.09 | 0.52 | 0.06, 4.20 |
Caesarean section | |||||
No | 21.0 | 1.00 | 1.00 | ||
Yes | 33.3 | 1.88 | 1.04, 3.40 | 2.86 | 0.15, 56.32 |
Preeclampsia | |||||
No | 22.8 | 1.00 | 1.00 | ||
Yes | 33.3 | 1.69 | 0.86, 3.35 | 1.32 | 0.59, 3.01 |
Polyhydramnios | |||||
No | 24.6 | 1.00 | 1.00 | ||
Yes | 50.0 | 3.06 | 0.18, 49.72 | 2.32 | 0.11, 48.31 |
Endometritis | |||||
No | 24.7 | 1.00 | – | ||
Yes | 50.0 | 3.05 | 0.19, 49.5 | – | – |
Prevalence and factors associated with neonatal low Apgar Score < 7 at 5 min
Variables | Prevalence of low Apgar score (%) | OR | 95% CI | AOR | 95% CI |
---|---|---|---|---|---|
Maternal sociodemographic factors | |||||
Age (years) | |||||
18–25 | 15.2 | 1.00 | 1.00 | ||
26–35 | 13.9 | 0.90 | 0.36, 2.27 | 0.97 | 0.26, 3.59 |
≥ 36 | 8.2 | 0.50 | 0.14, 1.82 | 0.18 | 0.02, 1.44 |
Race/ethnicity | |||||
Othersa | 9.1 | 1.00 | 1.00 | ||
Itaukei Fijians | 11.2 | 1.26 | 0.27, 5.98 | 1.32 | 0.20, 8.61 |
FIDs | 16.0 | 1.91 | 0.41, 8.94 | 1.60 | 0.21, 11.92 |
Educational level | |||||
Non-tertiary (primary/secondary) | 16.0 | 1.00 | 1.00 | ||
Tertiary (university/polytechnic) | 8.7 | 0.50 | 0.22, 1.16 | 0.54 | 0.18, 1.62 |
Marital status | |||||
Not married | 10.3 | 1.00 | 1.00 | ||
Married | 13.4 | 1.34 | 0.38, 4.70 | 1.66 | 0.35, 7.85 |
Gravidity (number of pregnancies) | |||||
Primigravid (first pregnancy) | 11.8 | 1.00 | 1.00 | ||
Multiparous (2/more children) | 14.3 | 1.25 | 0.41, 3.85 | 2.77 | 0.58, 13.29 |
Grand multiparous (≥5 children) | 9.1 | 0.75 | 0.17, 3.24 | 1.77 | 0.19, 16.60 |
Maternal risk factors (yes, no) | |||||
Family history of diabetes | |||||
No | 13.4 | 1.00 | 1.00 | ||
Yes | 12.7 | 0.94 | 0.45, 1.96 | 1.40 | 0.52, 3.76 |
Previous baby > 4 kg | |||||
No | 13.6 | 1.00 | 1.00 | ||
Yes | 10.9 | 0.78 | 0.30, 1.99 | 1.64 | 0.45, 5.95 |
Previous neonatal death | |||||
No | 13.2 | 1.00 | 1.00 | ||
Yes | 10.0 | 0.73 | 0.09, 5.98 | 1.49 | 0.12, 18.50 |
Maternal BMI (kg/m2) | |||||
Underweight/normal (< 25) | 14.7 | 1.00 | 1.00 | ||
Overweight (25–29.9) | 22.5 | 1.68 | 0.50, 5.62 | 1.58 | 0.37, 6.70 |
Obese (classes 1–3, ≥30.0) | 10.7 | 0.69 | 0.24, 2.03 | 0.28 | 0.07, 1.16 |
Antenatal factors | |||||
Booking age of gestation (weeks) | |||||
1st trimester (0–13) | 11.4 | 1.00 | 1.00 | ||
2nd trimester (14–27) | 12.9 | 1.15 | 0.49, 2.72 | 1.46 | 0.44, 4.85 |
3rd trimester (≥28) | 16.7 | 1.56 | 0.54, 4.53 | 7.87 | 1.11, 55.75* |
Age of gestation at GDM diagnosis (weeks) | |||||
1st trimester (0–13) | 11.5 | 1.00 | 1.00 | ||
2nd trimester (14–27) | 15.5 | 1.40 | 0.38, 5.19 | 1.53 | 0.24, 10.01 |
3rd trimester (≥27) | 11.1 | 0.96 | 0.25, 3.64 | 0.53 | 0.06, 4.56 |
Age of gestation at delivery (weeks) | |||||
< 37 | 27.9 | 1.00 | 1.00 | ||
37–41 | 10.0 | 0.29 | 0.13, 0.64* | 0.14 | 0.04, 0.46* |
Maternal post-pregnancy factors | |||||
Delivery intervention | |||||
Induced labour | |||||
No | 10.6 | 1.00 | 1.00 | ||
Yes | 14.3 | 1.41 | 0.62, 3.18 | 0.16 | 0.01, 2.52 |
Caesarean section | |||||
No | 15.4 | 1.00 | 1.00 | ||
Yes | 7.7 | 0.46 | 0.18, 1.16 | 2.86 | 0.16, 56.32 |
Preeclampsia | |||||
No | 11.2 | 1.00 | 1.00 | ||
Yes | 20.8 | 2.08 | 0.92, 4.73 | 5.57 | 1.73, 18.00* |
Polyhydramnios | |||||
No | 12.8 | 1.00 | 1.00 | ||
Yes | 50.0 | 6.84 | 0.42, 112.15 | 10.51 | 0.34, 326.38 |