ABSTRACT Objectives: Since it has been suggested that moderate alcohol drinking would increase insulin sensitivity, which could benefit Gestational Diabetes Mellitus (GDM), the study aimed at evaluating alcohol consumption during pregnancy, and seeing whether this consumption influences GDM detection and maternal/perinatal outcomes. Study design: Women with already known diabetes and those with multiple pregnancy were excluded. All other pregnant women attending antenatal care unit of the university clinics, Kinshasa, DR Congo during the period from 1 March throughout 31 October 2010, were invited at 24-week gestation to enroll in O’Sullivan blood glucose testing and if eligible in 100-gram oral glucose tolerance test. Alcohol consumption, risk factors for GDM, and general characteristics such as age, parity, gestity, BMI, fat mass were registered. Diagnosed GDM was first treated with diet and exercise, thereafter with Metformin, and if necessary with insulin. For other (normal) women data remained blinded until confinement. Maternal and infant’s adverse outcomes such as maternal urinary infection, preeclampsia, cesarean section, intrauterine growth retardation, birth weight < 2500 g, birth weight ≥ 3800 g (as stated > percentile 90 in our milieu), Apgar score at the first minute < 7, shoulder dystocia or other birth injury, neonatal hypoglycemia and fetal alcohol syndrome (FAS) were compared and analyzed according to GDM diagnosis as well to alcohol status. Results: Up to 240 pregnant women accepted to enroll into the study. Alcohol consumption concerned 78 (32.5%) of the women, most of them (61 = 25.42%) being heavy consumers. Risk factors for GDM and Physical and blood glucose characteristics were alike (p not significant) in both consumers and non consumers, except for history of HTA in the family that was significantly more frequent (p = 0.02) among drinkers. GDM’s prevalence was 9%. No adverse outcome was more prominent in any subgroup, except Apgar score < 7 at the first minute that was more frequent (p = 0.038) among neonates of GDM mothers. No FAS, neither shoulder dystocia nor neonatal hypoglycemia were diagnosed. When alcohol status was considered, Birthweight ≥ 3800 g was found more frequent (p = 0.0284) in alcohol consumers than in abstainers. Risk of this outcome was three times higher when history of family hypertension was present (odds ratio 2.694; CI: 0.536 - 13.544). Conclusions: The prevalence of alcohol consumption by pregnant women of our series (32.5%) seems not to impact the detection of GDM (9%). FAS was not diagnosed. Lack of significant differences in adverse outcomes between GDM and non GDM could be attributed to huge follow-up of GDM women. Influence of alcohol consumption on birth weight mostly in setting of familial history of hypertension remains to be addressed.
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nullBarthélémy, T. , Andy, M. and Roger, M. (2011) Effect of maternal alcohol consumption on gestational diabetes detection and mother-infant’s outcomes in Kinshasa, DR Congo. Open Journal of Obstetrics and Gynecology, 1, 208-212. doi: 10.4236/ojog.2011.14040.
 Hanson, J.W., Streissguth, A.P. and Smith, D.W. (1978) The effects of moderate alcohol consumption during pregnancy on fetal growth and morphogenesis. Journal of Pediatrics, 92, 457-460.
 Little, R.E. (1990) Moderate alcohol use during pregnancy and decreased infant birth weight. Pediatrics, 85, 1-9.
 Ebrahim, S.H., Anderson, A.L. and Floyd, R.L. (1999) Alcohol consumption by reproductive-aged women in the USA: An update on assessment, burden and prevention in the 1990s. Prenatal and Neonatal Medicine, 4, 419-430.
 Mukherjee, R.A.S., S. Hollins, M.T. and Abou-Saleh, J.T. (2005) Low level alcohol consumption and the fetus. British Medical Journal, 330, 375-376.
 Strandberg-Larsen, K., Nielsen, N.R., Gronbaek, M., Andersen, P.K., Olsen, J. and Andersen, A.M. (2008) Binge drinking in pregnancy and risk of fetal death. Obstetrics and Gynecology, 111, 602-609.
 Joosten, M.M., Chiuve, S.E., Mukamal, K.J., Hu, F.B., Hendriks, H.F. and Rimm, E.B. (2011) Changes in alcohol consumption and subsequent risk of type 2 diabetes in men. Diabetes, 60, 74-79. doi:10.2337/db10-1052
 Tandu-Umba, N.F.B., Paka M.A., Mbungu, M.R. and Muls, E. (2009) Détermination de la prévalence du diabète gestationnel et des facteurs associés à Kinshasa. Annales Africaines de Médecine, 3, 321-325.
 The HAPO Study Cooperative Research Group (2008) Hyperglycemia and Adverse Pregnancy Outcomes. The New England Journal of Medicine, 358, 1991-2002.
 O’Connor, M.J., Tomlinson, M., LeRoux, I.M., Stewart, J., Greco, E. and Rotheram-Borus, M.J. (2011) Predictors of alcohol use prior to pregnancy recognition among township women in Cape Town, South Africa. Social Sciences and Medicine, 72, 83-90.
 Potukuchi, P.S. and Rao, P.G. (2010) Problem alcohol drinking in rural women of Telangana region, Andhra Pradesh. Indian Journal of Psychiatry, 52, 339-343.
 Centers for Disease Control and Prevention (2004) Alcohol consumption among women who are pregnant or might become pregnant-United States, 2002. Morbidity and Mortality Weekly Reports, 53, 1178-1181.
 Chassevent-Pajot, A., Guillou-Landréat, M., Grall-Bronnec, M., Wainstein, L., Philippe, H.J., Lombrail, P. and Vénisse, J.L. (2011) étude de prévalence des conduites addictives chez les femmes enceintes dans une maternité universitaire. Journal de Gynécologie, Obstétrique et Biologie de la Reproduction, 40, 237-245.
 Mullally, A., Cleary, B.J., Barry J., Fahey, T.P. and Murphy, D.J. (2011) Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure—retrospective cohort study in an urban obstetric population in Ireland. BMC Pregnancy Childbirth, 11, 11-27.
 King, J.C. (1997) Substance abuse in pregnancy: A bigger problem than you think. Postgraduate Medicine, 102, 135-150. doi:10.3810/pgm.1997.09.313
 Jacobson, J. and Jacobson, S. (1999) Drinking moderately and pregnancy effects on child development. Alcohol Research and Health, 23, 25-30.
 Carson, G., Cox, L.V., Crane, J., Croteau, P., Graves, L., Kluka, S., Koren, G., Martel, M.J., Midmer, D., Nulman, I., Poole, N., Senikas, V. and Wood, R. (2010) Society of obstetricians and gynaecologists of canada. Alcohol use and pregnancy consensus clinical guidelines. Journal of Obstetrics and Gynaecology of Canada, 32, S1-S31.
 Liu, C., Yu, Z., Li, H., Wang, J., Sun, L., Qi, Q. and Lin, X. (2010) Associations of Alcohol consumption with diabetes mellitus and impaired fasting glycemia among middle-aged and elderly Chinese. BMC Public Health, 10, 713-728. doi:10.1186/1471-2458-10-713