Publication:

Adverse maternal and neonatal outcomes among women with gestational diabetes mellitus: a retrospective cohort study in Western Kenya

Background Gestational diabetes mellitus (GDM) is a growing public health concern associated with adverse maternal and neonatal outcomes, yet evidence from Sub-Saharan Africa, including Kenya, remains limited. This study examined the association between GDM and adverse maternal and neonatal outcomes among women delivering at a tertiary hospital in western Kenya and identified key risk factors for these outcomes.

Methods A retrospective case-control study was conducted using hospital and maternal fetal medicine (MFM) registry records from January 2020 to December 2022. A total of 210 women were analyzed, 105 with GDM and 105 without, matched by age, parity, and gestational age at delivery. Data on demographic, obstetric, and clinical characteristics were extracted and analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression to determine independent predictors of adverse outcomes.

Results Women with GDM had significantly higher rates of cesarean delivery (58% versus 40%), postpartum hemorrhage (21% versus 7.6%), and macrosomia (21% versus 1%) compared to those without GDM (p<0.05). Newborn unit admissions (44% versus 27%) and respiratory distress syndrome (15% versus 6.7%) were also more common among infants born to GDM mothers, consistent with previous findings. Obesity (aOR=11.3; 95% CI: 4.3-32.5), prior history of GDM (aOR=4.7; 95% CI: 1.3-22.7), and advanced maternal age emerged as independent predictors of adverse outcomes.

Conclusions These findings demonstrates that GDM substantially increases the risk of maternal and neonatal complications in this setting. Strengthened screening between 24 and 28 weeks of gestation, targeted management, and structured postpartum follow-up are recommended to improve outcomes and reduce the long-term burden of diabetes among mothers and infants.