Gestational Diabetes Mellitus in Guyana: Clinical Profiles, Obstetric Outcomes, and Predictors of Adverse Events — A Retrospective Cohort Analysis
Abstract:
Gestational diabetes
mellitus (GDM) is a growing metabolic complication of pregnancy with
significant public health implications in low- and middle-income countries.
This retrospective cohort study characterises the clinical and obstetric
profiles of 33 GDM-confirmed mothers who delivered at the Georgetown Public
Hospital Corporation (GPHC), Guyana, in January to June 2017, and identifies
predictors of adverse maternal and neonatal outcomes. Data were extracted from
hospital charts using a standardised abstraction form covering
sociodemographic, anthropometric, obstetric, glycaemic, and neonatal variables.
The cohort had a mean age of 29.9 ± 6.6 years and was predominantly
Afro-Guyanese (60.6%) and urban-dwelling (75.8%). Mean pre-pregnancy body mass
index (BMI) was 32.1 ± 10.4 kg/m², with 57.6% classified as overweight or
obese. Family history of diabetes was present in 21.2% of participants. Insulin
monotherapy or combination regimens were used in 97.0% of cases. Caesarean
section rate was 45.5%, and gestational hypertension was the most frequent
complication, affecting 36.4% of the cohort. Macrosomia occurred in 15.2% of
births (mean birth weight 3,392 ± 676 g). Breastfeeding was initiated by 84.8%
of participants. Postpartum metabolic follow-up data were absent across all
time points, representing a critical systemic gap. Findings underscore the need
for preconception BMI screening, structured postpartum surveillance registries,
and culturally tailored non-communicable disease prevention strategies for women
with a history of GDM in Guyana.
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