Postpartum hyperglycemia and associated factors among women attending postnatal clinics in Dar es salaam: a cross-sectional study

Abstract Background The prevalence of Gestational Diabetes Mellitus in Tanzania is raising paralleling its contribution to maternal morbidity and mortality. Studies have reported a prevalence of postpartum hyperglycemia in Africa to be 15% with 48% of the women progressing to T2DM five years postpartum. Carbohydrate dense diet has been correlated with glucose intolerance in most pregnant women. However, evidence is scarce and not systematic on factors associated with post-partum hyperglycemia in Tanzania. This study assessed nutritional and lifestyle factors associated with postpartum hyperglycemia among women attending postnatal clinics in Dar es salaam. Methods We conducted an analytical, hospital based cross-sectional study in postnatal clinics based in Dar es Salaam, Tanzania. A multistage simple random sampling method was used to determine the three health centers and recruit women attending postnatal clinic from April to June 2025. Structured questionnaires were used to collect data, descriptive statistics was done using mean, proportion and chi-square test. We employed a univariable and multivariable modified poisson regression analysis to determine the association of independent variables with postpartum hyperglycemia. The p-value of <0.05 was considered statistically significant. Results We enrolled 392 postpartum women, from Sinza health center (HC) (48%), Magomeni HC (28.3%) and Kinyerezi HC (23.7%) with the mean age of 31.52 (±7.54). Postpartum hyperglycemia was prevalent among 18.6% of the women. The prevalence of postpartum hyperglycemia was higher among women with higher BMI (overweight and obese) (APR= 8.1, p<0.001, 11.6, p<0.001) respectively, and those with refined carbohydrate dietary pattern (APR= 1.54, p=0.022), while diet rich in legumes and vegetables was protective against postpartum hyperglycemia (APR= 0.69, p=0.001), after adjusting for potential confounders. Conclusion About one in five postpartum women had hyperglycemia and it is linked to modifiable nutritional and dietary factors. These include overweight, obesity and consumption of refined carbohydrate, while protein and legumes were protective factors. Attention should be put to prioritizing nutrition education and promotion of healthy lifestyle during peripartum period to ensure optimal glucose control in the postpartum period.