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Risk of dysglycemia in pregnancy amongst Kenyan women with HIV infection: a nested case-control analysis from the STRiDE study
Pastakia, Sonak D . Kosgei, Wycliffe K Christoffersen-Deb, Astrid Kiragu, Benson Hector, John N Anusu, Gertrude Saravanan, Ponnusamy
Pastakia, Sonak D
. Kosgei, Wycliffe K
Christoffersen-Deb, Astrid
Kiragu, Benson
Hector, John N
Anusu, Gertrude
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Affiliation
Purdue University College of Pharmacy, Indianapolis, USA; Academic Model Providing Access to Healthcare, Eldoret, Kenya; Moi Teaching and Referral Hospital, AMPATH Plus-RMNCAH/FP, Kenya; University of British Columbia, Canada; University of Toronto, Canada; University of Warwick; George Eliot Hospital NHS Trust, Nuneaton
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Publication date
2021-04-05
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Abstract
Introduction. Gestational diabetes is a common complication, whose incidence is growing globally. There is a pressing need to obtain more data on GDM in low- and middle-income countries, especially amongst high-risk populations, as most of the data on GDM comes from high-income countries. With the growing awareness of the role HIV plays in the progression of noncommunicable diseases and the disproportionate HIV burden African countries like Kenya face, investigating the potential role HIV plays in
increasing dysglycemia amongst pregnant women with HIV is an important area of study. Methods. The STRiDE study is one of
the largest ever conducted studies of GDM in Kenya. This study enrolled pregnant women aged between 16 and 50 who were
receiving care from public and private sector facilities in Eldoret, Kenya. Within this study, women received venous testing for
glycosylated hemoglobin (HbA1c) and fasting glucose between 8- and 20-week gestational age. At their 24-32-week visit, they
received a venous 75 g oral glucose tolerance test (OGTT). Because of the pressing need to assess the burden of GDM within the
population of pregnant women with HIV, a nested case-control study design was used. Pregnant women with HIV within the
larger STRiDE cohort were matched to non-HIV-infected women within the STRiDE cohort at a 1 : 3 ratio based on body mass
index, parity, family history of GDM, gestational age, and family history of hypertension. The measurements of glucose from the
initial visit (fasting glucose and HbA1c) and follow-up visit (OGTT) were compared between the two groups of HIV+ cases and
matched HIV- controls. Results. A total of 83 pregnant women with HIV were well matched to 249 non-HIV-infected women
from the STRiDE cohort with marital status being the only characteristic that was statistically significantly different between the
two groups. Statistically significant differences were not observed in the proportion of women who developed GDM, the fasting
glucose values, the HbA1c, or OGTT measurements between the two groups. Discussion. Significant associations were not seen
between the different measures of glycemic status between pregnant women with and without HIV. While significant differences
were not seen in this cohort, additional investigation is needed to better describe the association of dysglycemia with HIV,
especially in Kenyan populations with a higher prevalence of GDM.
Citation
Pastakia SD, Kosgei WK, Christoffersen-Deb A, Kiragu B, Hector JN, Anusu G, Saravanan P. Risk of Dysglycemia in Pregnancy amongst Kenyan Women with HIV Infection: A Nested Case-Control Analysis from the STRiDE Study. J Diabetes Res. 2021 Apr 5;2021:8830048. doi: 10.1155/2021/8830048.
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Article