Incidence and Types of Fetal Complications in Diabetic Pregnant Mothers: Implications of a Tenfold Sample Size Increase at Khartoum Maternity Hospital, Khartoum State, Sudan
Keywords:
Gestational diabetes mellitus, fetal complications, Sudan, maternal health, epidemiology, macrosomia, sampling strategy, neonatal outcomes, Khartoum.Abstract
Background: Gestational diabetes mellitus (GDM) poses a significant risk to both maternal and neonatal health, particularly in resource-limited settings like Sudan. Initial research from Khartoum Maternity Hospital identified fetal complications in a small cohort of 76 diabetic pregnant women. However, the limited sample size constrained generalizability and statistical power.
Objective: To assess the incidence and spectrum of fetal complications in diabetic pregnancies using an expanded cohort of 760 participants, and to develop a scalable, methodologically robust model for large-scale epidemiologic maternal-fetal research in Sudan.
Methods: The study adopts a three-stage sampling design: cluster sampling of hospitals, stratified random sampling by risk factors (e.g., BMI, age, proteinuria), and systematic recruitment within strata. It employs Electronic Data Capture (EDC) systems, centralized oversight (hub-and-spoke model), and advanced statistical techniques including Generalized Linear Models and multivariate analysis to evaluate predictors of fetal complications.
Results: The methodological upgrade is expected to increase statistical power, improve estimate precision, and detect rare complications such as macrosomia, stillbirth, and neonatal hypoglycemia. Stratified analysis will further delineate risk patterns among demographic subgroups.
Conclusion: This expansion transforms a limited observational study into a robust epidemiologic investigation with actionable policy relevance. The study sets a precedent for maternal health surveillance in low-resource and conflict-affected regions.
