evaluation of the latest ADA criteria for screening and diagnosing gestational diabetes at a tertiary care hospital in the United Arab Emirates

The American Diabetic Association [ADA] has recently recommended lowering the cut-off values for the two-step oral glucose tolerance test [OGTT] used for screening of gestational diabetes. This study reports on the appropriateness of applying the latest ADA diagnostic criteria when screening for gestational diabetes mellitus [GDM] in a tertiary care facility in the United Arab Emirates. The study was carried out at Mafraq Hospital, Abu Dhabi, United Arab Emirates [UAE] between November 1999 and April 2001. A total of 889 pregnant women who underwent at least one test of the two-step OGTT were studied retrospectively for adverse maternal and fetal outcomes. Subjects were classified as GDM positive or negative by applying the old and the latest ADA criteria and the occurrence of adverse outcomes in the various groups was compared. Applying the latest ADA criteria with the two-step OGTT identified 11% and 17% more patients at risk for fetal and maternal adverse outcomes respectively. Advanced maternal age [> 30 years in our population], multi-parity [> 4] and obesity [BMI > 30] were associated with increased risk of being diagnosed as having GDM. Application of the latest ADA criteria to the two-step OGTT was determined to be appropriate for UAE pregnant women tested for GDM in the tertiary care setting. Older [age > 30 years], multiparous [parity > 4], and obese women [BMI > 30] were at greater risk of GDM diagnosis by the latest ADA criteria

Analysis of hyperbilirubinemia in Omani newborn babies

Jaundice in newborn babies is caused by a number of etiological factors, some of which may vary from place to place. This study was aimed at identification of etiological factors for jaundice in our region. We studied 150 babies at Khoula Hospital, Muscat, between January and June 2003 for significant clinical jaundice extending at least up to the trunk area and analyzed relevant maternal and infant data. Glucose-6-Phosphate dehydrogenase [G6PD] deficiency and ABO incompatibility were seen causing jaundice in 52% of the babies. The mean age at maximum serum bilirubin [SBR] was 82.9 hours [S.E 3.1] and the mean maximum SBR was 254.5 micro mol/L [SE 6.1]. G6PD deficiency and ABO incompatibility remain the major causative factors for jaundice in this population and there is a need to closely monitor babies with family history of G6PD deficiency for jaundice in first few days of life

Trends and causes of perinatal mortality in Muscat region

Despite improvements in antenatal care, the perinatal mortality in the Sultanate of Oman remains high compared to the developed countries. This study was aimed at the identification of rates, causes and risk factors affecting the perinatal mortality at Khoula Hospital in Muscat region. The study covered 100 stillbirths and 60 neonatal deaths from January 1999 through December 2001, out of a total of 10,896 babies born in this hospital during this period. The still birth rate was 10.7 per thousand births and early neonatal death rate was 5.5 per thousand live births with an overall perinatal mortality rate of 16.2 per 1000 births. The major risk factors identified were maternal morbidity in the form of diabetes, toxemia and hypertension, rural hospital care and male sex. 39% stillbirths were fresh and 59% babies weighed more than 2 kilograms. 48% were of more than 37 weeks gestation. 77% mothers were between 20 to 35 years of age. 68% mothers had more than 6 antenatal visits and 76% mothers visited for antenatal care in the first trimester with 88% visiting the hospital at least once during the last 4 weeks of pregnancy. The main reasons for early neonatal deaths were gross prematurity, pulmonary hypoplasia secondary to congenital renal anomalies, and multiple congenital anomalies with 25% babies weighing less than 750 grams. Conclusions: Stillbirths occur with equal frequency in all age groups of mothers in our region. There is a trend towards a decrease in the still birth rate, which is the main contributor to a high perinatal mortality rate in this region. Improvements in antenatal care during the last 4 weeks of pregnancy in moribund mothers and icreasing support for the gross preterm babies will lead to a marked improvement in perinatal mortality rates