title: Maternal hyperglycemia and adverse pregnancy outcomes in Dar es Salaam, Tanzania.
abstract: OBJECTIVE
  To evaluate maternal glucose levels during pregnancy as a predictor of adverse perinatal outcomes in Dar es Salaam, Tanzania.
  
  
  METHODS
  Random blood glucose measurements were analyzed from 3383 pregnant women enrolled in a randomized trial to assess the impact of multivitamins on pregnancy outcomes in Dar es Salaam between August 2001 and July 2004. Information on maternal and neonatal morbidity was recorded at monthly study visits, delivery, and 6 weeks postpartum. Binomial regression and generalized estimating equations were used to determine the relationship between elevated glucose (>7.8 mmol/L) and pregnancy outcomes.
  
  
  RESULTS
  In total, 25 women had elevated glucose (0.7%). Hyperglycemia was associated with an increased risk of delivery before 37 weeks [relative risk (RR), 2.11; 95% confidence interval [CI], 1.07-4.13; P=0.03), delivery before 34 weeks (RR, 4.15; 95% CI, 1.43-12.03, P=0.009), incident gestational hypertension (RR, 2.90; 95% CI, 1.24-6.76; P=0.01), low birth weight (RR, 2.87; 95% CI, 1.18-6.99; P=0.02), reduced newborn head circumference (mean difference, -1.57; 95% CI, -2.51 to -0.62; P=0.001), and fetal loss (RR, 3.38; 95% CI, 1.13-10.08; P=0.03).
  
  
  CONCLUSIONS
  Maternal hyperglycemia is uncommon among pregnant Tanzanian women, but nonetheless seems to increase the risk of several adverse perinatal outcomes.
authors: Department of Global Health and Population, Harvard School of Public Health, Boston, USA. Electronic address: adarling@hsph.harvard.edu.
authors: Anne Marie
authors: AM
authors: Darling
authors: Department of Global Health and Population, Harvard School of Public Health, Boston, USA.
authors: Enju
authors: E
authors: Liu
authors: Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors: Said
authors: S
authors: Aboud
authors: Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors: Willy
authors: W
authors: Urassa
authors: Department of Epidemiology, Harvard School of Public Health, Boston, USA; Department of Biostatistics, Harvard School of Public Health, Boston, USA.
authors: Donna
authors: D
authors: Spiegelman
authors: Department of Global Health and Population, Harvard School of Public Health, Boston, USA; Department of Epidemiology, Harvard School of Public Health, Boston, USA; Department of Nutrition, Harvard School of Public Health, Boston, USA.
authors: Wafaie
authors: W
authors: Fawzi
mesh_terms: D000328:Adult; D001786:Blood Glucose; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000503:physiopathology*; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012189:Retrospective Studies; D013636:Tanzania; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Africa; Gestational hyperglycemia; Gestational hypertension; Low birth weight; Preterm birth; Stillbirth