Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Self-reported diabetes during pregnancy in the South African National Health and Nutrition Examination Survey: extent and social determinants

Authors: Lumbwe Chola, Chipo Mutyambizi, Ronel Sewpaul, Whadi-ah Parker, Zandile Mchiza, Demetre Labadarios, Charles Hongoro

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

Login to get access

Abstract

Background

Diabetes is a serious and growing public health concern in South Africa, but its prevalence and distribution in pregnant women is not well known. Women diagnosed with diabetes during pregnancy have a substantially greater risk of adverse health outcomes for both mother and child. This study aims to determine the prevalence and social determinants of diabetes during pregnancy in South Africa.

Methods

Data used in this study were from the 2012 South African National Nutrition and Health Examination Survey; a nationally representative cross-sectional household survey. The analysis was restricted to girls and women between the ages of 15 to 49 years who self-reported ever being pregnant (n = 4261) Logistic regression models were constructed to analyse the relationship between diabetes during pregnancy and several indicators including race, family history of diabetes, household income, area of residence and obesity.

Results

The prevalence of diabetes during pregnancy in South Africa was 3% (144 women) of all women who reported ever being pregnant. The majority of the women who had ever had diabetes were African (70%), 51% were unemployed and 76% lived in rural areas. Factors strongly associated with diabetes during pregnancy were age (1.04 [Odds Ratio], 0.01 [Standard Error]), family history of diabetes (3.04; 0.8) and race (1.91; 0.53).

Conclusion

The analysis will contribute to an understanding of the prevalence of diabetes during pregnancy and its social determinants. This will help in the development of effective interventions targeted at improving maternal and child health for mothers at high risk.
Literature
1.
go back to reference Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang Y-H, Stevens GA, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2 · 7 million participants. Lancet. 2011;378(9785):31–40.CrossRefPubMed Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang Y-H, Stevens GA, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2 · 7 million participants. Lancet. 2011;378(9785):31–40.CrossRefPubMed
2.
go back to reference NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants. Lancet. 2016;387(10027):1513–30.CrossRef NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants. Lancet. 2016;387(10027):1513–30.CrossRef
3.
go back to reference Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137–49.CrossRefPubMed Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137–49.CrossRefPubMed
4.
go back to reference Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4–14.CrossRefPubMed Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4–14.CrossRefPubMed
5.
go back to reference Bertram MY, Jaswal AVS, Van Wyk VP, Levitt NS, Hofman KJ. The non-fatal disease burden caused by type 2 diabetes in South Africa, 2009. Global Health Action. 2013;6. doi:10.3402/gha.v6i0.19244. Bertram MY, Jaswal AVS, Van Wyk VP, Levitt NS, Hofman KJ. The non-fatal disease burden caused by type 2 diabetes in South Africa, 2009. Global Health Action. 2013;6. doi:10.​3402/​gha.​v6i0.​19244.
7.
go back to reference Hunt KJ, Schuller KL. The Increasing Prevalence of Diabetes in Pregnancy. Obstet Gynecol Clin N Am. 2007;34(2):173–vii.CrossRef Hunt KJ, Schuller KL. The Increasing Prevalence of Diabetes in Pregnancy. Obstet Gynecol Clin N Am. 2007;34(2):173–vii.CrossRef
8.
go back to reference Gilmartin ABH, Ural SH, Repke JT. Gestational Diabetes Mellitus. Rev Obstetr Gynecol. 2008;1(3):129–34. Gilmartin ABH, Ural SH, Repke JT. Gestational Diabetes Mellitus. Rev Obstetr Gynecol. 2008;1(3):129–34.
10.
go back to reference Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, Dong L, Li L, Yu Z, Chan JCN, et al. Prevalence of Gestational Diabetes Mellitus and Its Risk Factors in Chinese Pregnant Women: A Prospective Population-Based Study in Tianjin, China. PLoS One. 2015;10(3), e0121029.CrossRefPubMedPubMedCentral Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, Dong L, Li L, Yu Z, Chan JCN, et al. Prevalence of Gestational Diabetes Mellitus and Its Risk Factors in Chinese Pregnant Women: A Prospective Population-Based Study in Tianjin, China. PLoS One. 2015;10(3), e0121029.CrossRefPubMedPubMedCentral
11.
go back to reference DeSisto CL, Kim SY, Sharma AJ. Prevalence Estimates of Gestational Diabetes Mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis. 2014;11, E104.CrossRefPubMedPubMedCentral DeSisto CL, Kim SY, Sharma AJ. Prevalence Estimates of Gestational Diabetes Mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis. 2014;11, E104.CrossRefPubMedPubMedCentral
12.
go back to reference Shand AW, Bell JC, McElduff A, Morris J, Roberts CL. Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998–2002. Diabet Med. 2008;25(6):708–15.CrossRefPubMed Shand AW, Bell JC, McElduff A, Morris J, Roberts CL. Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998–2002. Diabet Med. 2008;25(6):708–15.CrossRefPubMed
13.
go back to reference Lapolla A, Dalfra MG, Di Cianni G, Bonomo M, Parretti E, Mello G, Scientific Committee of the GG. A multicenter Italian study on pregnancy outcome in women with diabetes. Nutr Metab Cardiovas Dis. 2008;18(4):291–7.CrossRef Lapolla A, Dalfra MG, Di Cianni G, Bonomo M, Parretti E, Mello G, Scientific Committee of the GG. A multicenter Italian study on pregnancy outcome in women with diabetes. Nutr Metab Cardiovas Dis. 2008;18(4):291–7.CrossRef
14.
go back to reference Persson M, Norman M, Hanson U. Obstetric and Perinatal Outcomes in Type 1 Diabetic Pregnancies: A large, population-based study. Diabetes Care. 2009;32(11):2005-2009 Persson M, Norman M, Hanson U. Obstetric and Perinatal Outcomes in Type 1 Diabetic Pregnancies: A large, population-based study. Diabetes Care. 2009;32(11):2005-2009
15.
go back to reference Huddle KR. Audit of the outcome of pregnancy in diabetic women in Soweto, South Africa, 1992–2002. S Afr Med J = Suid-Afrikaanse tydskrif vir geneeskunde. 2005;95(10):789–94.PubMed Huddle KR. Audit of the outcome of pregnancy in diabetic women in Soweto, South Africa, 1992–2002. S Afr Med J = Suid-Afrikaanse tydskrif vir geneeskunde. 2005;95(10):789–94.PubMed
16.
go back to reference Basu JK, Jeketera CM, Basu D. Obesity and its outcomes among pregnant South African women. Int J Gynecol Obstet. 2010;110(2):101–4.CrossRef Basu JK, Jeketera CM, Basu D. Obesity and its outcomes among pregnant South African women. Int J Gynecol Obstet. 2010;110(2):101–4.CrossRef
17.
go back to reference Mamabolo RL, Alberts M, Levitt NS, Delemarre-van de Waal HA, Steyn NP. Prevalence of gestational diabetes mellitus and the effect of weight on measures of insulin secretion and insulin resistance in third-trimester pregnant rural women residing in the Central Region of Limpopo Province, South Africa. Diabet Med. 2007;24(3):233–9.CrossRefPubMed Mamabolo RL, Alberts M, Levitt NS, Delemarre-van de Waal HA, Steyn NP. Prevalence of gestational diabetes mellitus and the effect of weight on measures of insulin secretion and insulin resistance in third-trimester pregnant rural women residing in the Central Region of Limpopo Province, South Africa. Diabet Med. 2007;24(3):233–9.CrossRefPubMed
18.
go back to reference Labadarios D, Shisana O, Rehle T, Simbayi L. SANHANES: a unique survey series in the health landscape. S Afr Med J. 2014;104(10):675–6.CrossRefPubMed Labadarios D, Shisana O, Rehle T, Simbayi L. SANHANES: a unique survey series in the health landscape. S Afr Med J. 2014;104(10):675–6.CrossRefPubMed
19.
go back to reference McHiza ZJ, Parker WA, Makoae M, Sewpaul R, Kupamupindi T, Labadarios D. Body image and weight control in South Africans 15 years or older: SANHANES-1. BMC Public Health. 2015;15:992.CrossRefPubMedPubMedCentral McHiza ZJ, Parker WA, Makoae M, Sewpaul R, Kupamupindi T, Labadarios D. Body image and weight control in South Africans 15 years or older: SANHANES-1. BMC Public Health. 2015;15:992.CrossRefPubMedPubMedCentral
20.
go back to reference Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva: WHO; 2010. Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva: WHO; 2010.
21.
go back to reference Motala AA, Pirie FJ, Gouws E, Amod A, Omar MAK. High incidence of Type 2 diabetes mellitus in South African Indians: a 10-year follow-up study. Diabet Med. 2003;20(1):23–30.CrossRefPubMed Motala AA, Pirie FJ, Gouws E, Amod A, Omar MAK. High incidence of Type 2 diabetes mellitus in South African Indians: a 10-year follow-up study. Diabet Med. 2003;20(1):23–30.CrossRefPubMed
22.
go back to reference Winship WS, Beighton P. Genetic disorders in the Indian community of South Africa. SAMJ. 2011;101:481–4.PubMed Winship WS, Beighton P. Genetic disorders in the Indian community of South Africa. SAMJ. 2011;101:481–4.PubMed
23.
go back to reference Erasmus RT, Soita DJ, Hassan MS, Blanco-Blanco E, Vergotine Z, Kengne AP, Matsha TE. High prevalence of diabetes mellitus and metabolic syndrome in a South African coloured population: Baseline data of a study in Bellville, Cape Town. 2012;102(11 Pt 1):841–4. doi:10.7196/samj.5670. Erasmus RT, Soita DJ, Hassan MS, Blanco-Blanco E, Vergotine Z, Kengne AP, Matsha TE. High prevalence of diabetes mellitus and metabolic syndrome in a South African coloured population: Baseline data of a study in Bellville, Cape Town. 2012;102(11 Pt 1):841–4. doi:10.​7196/​samj.​5670.
24.
go back to reference Michalow J, Chola L, McGee S, Tugendhaft A, Pattinson R, Kerber K, Hofman K. Triple return on investment: the cost and impact of 13 interventions that could prevent stillbirths and save the lives of mothers and babies in South Africa. BMC Pregnancy Childbirth. 2015;15:39.CrossRefPubMedPubMedCentral Michalow J, Chola L, McGee S, Tugendhaft A, Pattinson R, Kerber K, Hofman K. Triple return on investment: the cost and impact of 13 interventions that could prevent stillbirths and save the lives of mothers and babies in South Africa. BMC Pregnancy Childbirth. 2015;15:39.CrossRefPubMedPubMedCentral
25.
go back to reference NDOH. Strategic Plan for Maternal, Newborn, Child and Women’s Health (MNCWH) and Nutrition in South Africa: 2012–2016. Pretoria: NDOH; 2012. NDOH. Strategic Plan for Maternal, Newborn, Child and Women’s Health (MNCWH) and Nutrition in South Africa: 2012–2016. Pretoria: NDOH; 2012.
26.
go back to reference NDOH. Guidelines for maternity care in South Africa: A manual for clinics, community health centres and district hospitals. Pretoria, South Africa: NDOH; 2015. NDOH. Guidelines for maternity care in South Africa: A manual for clinics, community health centres and district hospitals. Pretoria, South Africa: NDOH; 2015.
27.
go back to reference Stats SA. Millennium Development Goals: Country report 2015. Pretoria: Stats SA; 2015. Stats SA. Millennium Development Goals: Country report 2015. Pretoria: Stats SA; 2015.
28.
go back to reference ICSU, ISSC. Review of the Sustainable Development Goals: The Science Perspective. Paris: International Council for Science (ICSU); 2015. ICSU, ISSC. Review of the Sustainable Development Goals: The Science Perspective. Paris: International Council for Science (ICSU); 2015.
Metadata
Title
Self-reported diabetes during pregnancy in the South African National Health and Nutrition Examination Survey: extent and social determinants
Authors
Lumbwe Chola
Chipo Mutyambizi
Ronel Sewpaul
Whadi-ah Parker
Zandile Mchiza
Demetre Labadarios
Charles Hongoro
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-1218-z

Other articles of this Issue 1/2017

BMC Pregnancy and Childbirth 1/2017 Go to the issue