Abstract

Background: Gestational diabetes mellitus is defined as glucose intolerance first discovered in pregnancy. Globally, the prevalence of gestational diabetes mellitus is rising which is a severe and neglected threat to maternal and child health. There was no prior systematic review and meta-analysis studies conducted in Africa using the updated international diagnostic criteria. Therefore, this systematic review and meta-analysis were conducted to estimate the prevalence and determinants of gestational diabetes mellitus using the published studies carried out in African countries by using new diagnostic criteria.

Methods: This study used a systematic review and meta-analysis of published studies in Africa from January 2013 to November, 2018. The databases used were; PubMed, Scopus, Cochrane Library, EMBASE, Google Scholar, CINAHL, Web of Science, Science direct and African Journals Online using the relevant search terms. Data were extracted using the Joanna Briggs Institute tool for prevalence studies. The meta-analysis was conducted using STATA version 14 software. The heterogeneity and publication bias was assessed using the I² statistics and Egger’s test respectively. Random effects model was used to estimate the pooled prevalence and the associated factors of gestational diabetes mellitus.

Result: The overall pooled prevalence of gestational diabetes mellitus in Africa was 13.61% (95% CI: 10.99, 16.23), and 14.28 % (95% CI: 11.39, 17.16) in the sub-Saharan African region. The prevalence was highest in the Central African (20.4%), and the lowest was in Northern Africa (7.57%) sub- regions. Factors associated with gestational diabetes mellitus included overweight and obesity (OR =3.51; 95% CI =1.92, 6.40), ever had macrocosmic baby (OR =2.23; 95%CI = 1.12, 4,45), having family history of diabetes mellitus (OR =2.69; 95%CI=1.84, 3.91), having history of still birth (OR =2.92; 95%CI =1.23, 6.93), having history of abortion or miscarriage (OR = 2.21; 95%CI = 1.68, 2.92), chronic hypertension (OR = 2.49; 95% CI=1.35, 4.59) and previous history of gestational diabetes mellitus  (OR =14.16; 95% CI=2.39, 84.08).

Conclusions: The prevalence of gestational diabetes mellitus is high in Africa. Factors associated with gestational diabetes mellitus included overweight and obesity, ever had macrocosmic baby, having family history of diabetes mellitus, having history of still birth, having history of abortion or miscarriage, chronic hypertension and previous history of gestational diabetes mellitus. Interventions that target these factors are important in reducing gestational diabetes mellitus.

Key words: Gestational diabetes mellitus, determinants, overweight and obesity, macrocosmic, abortion, still birth, chronic hypertension, systematic review, Meta-analysis, Africa