A Prospective Cohort Study on the Association Between Elevated C-Reactive Protein and Gestational Diabetes Mellitus in a Nigerian Obstetric Population

Abstract

Background: Gestational Diabetes Mellitus (GDM) is a major public health concern with a diverse range of adverse maternal and neonatal outcomes. The global prevalence of GDM varies widely depending on the screening method, diagnostic criteria used, and the characteristics of the population used. Thus, identifying women with GDM, and implementing interventional strategies aimed at controlling glycaemic status would help to reduce maternal and neonatal morbidity and mortality. Objective: To investigate the association between first-trimester C-reactive protein levels and the development of gestational diabetes mellitus later in pregnancy. Study Design and Setting: A prospective cohort study was undertaken at the University of Abuja Teaching Hospital, Gwagwalada involving 145 eligible consenting pregnant women. Materials and Methods: C- reactive protein measurement was done at booking in the first trimester. The women were followed up with a single oral glucose tolerance test (OGTT) between 24-28 weeks for the development of gestational diabetes mellitus among women with normal and elevated C- reactive protein. Data collected was analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0 software. Quantitative variables were described using mean and standard deviation; qualitative variables were presented as percentages. The student t-test was used ‘to determine the association between continuous variables while the Chi-square test was used for categorical variables. A p-value of less than 0.05 was accepted as indicating statistical significance. Results: The incidence of gestational diabetes mellitus among women with normal C- reactive protein was 3.3%,
while the incidence of gestational diabetes mellitus among women with elevated C- reactive protein was 28.3%. The association between C- reactive protein and gestational diabetes mellitus was statistically significant with a p-value of <0.001 and a relative risk of 8.67. Conclusion: Findings from the study suggest that elevated C-reactive protein in the first trimester is a good predictor of the development of gestational diabetes mellitus later in pregnancy in a cohort of Nigerian pregnant women.