Knowledge and factors associated with screening for gestational diabetes mellitus of pregnant women among doctors and midwives at Kawempe National Referral Hospital and Kisenyi Health Center IV

Abstract

Background: Gestational diabetes is the commonest endocrine and metabolic disease encountered during pregnancy and is associated with adverse maternal and fetal outcomes such as fetal macrosomia, perinatal death, and future risk of developing Type 2 diabetes mellitus in the mother. The burden of gestational diabetes is increasing worldwide currently at 17%, therefore it is essential to screen all pregnant women for gestational diabetes mellitus (GDM) between 24 to 28 weeks to detect the disease early to minimize its complications. With improvement in antenatal care attendance, it is a great opportunity to screen pregnant women and initiate treatment for those with GDM. This needs to be driven by the frontline health care workers who manage pregnant women. This study was designed to determine the level of knowledge and the factors associated with screening for gestational diabetes among pregnant women in selected facilities in Kampala. Methods: A cross-sectional study was conducted at Kawempe National Referral Hospital and Kisenyi HCIV. 384 participants gave informed consent and the consecutive method of sampling was used. Self-administered and structured questionnaires were used for data collection. The average score of knowledge for screening for gestational diabetes was determined. Results: The median age of study participants was 33.5 years with an interquartile range of 28 and 40 years. We found a gap in knowledge of GDM screening among study participants. The average score of adequate knowledge was 45.4%. and a score of 54.6%% had inadequate knowledge. Only 25.8% of participants knew OGTT as the investigation of choice. Only 12.5% of participants answered correctly the period for the common occurrence of GDM between 24 – 28 weeks gestation. Those who practiced having screened a pregnant woman for GDM were 73.3% and never screened were 26.8%. Conclusions and Recommendations: The study showed a gap in knowledge of GDM screening among study participants, adequate knowledge was observed on risk factors and complications but three-quarters of them lacked adequate knowledge on key items such as timing for screening and the investigation of choice. Focused training, use of protocols, and policy guidelines should be considered to improve gestation diabetes screening at Kawempe Hospital and Kisenyi HCIV.