Collection of outcome data
Maternal and neonatal outcomes were extracted from mothers’ records at the time of delivery and recorded by midwives. These included: maternal antenatal complications (hypertensive disorders of pregnancy, poly/oligohydramnios), delivery complications (prolonged labour, ruptured uterus, shoulder dystocia), mode of delivery, birthweight and gestational age of neonate. Hypertensive disorders of pregnancy included gestational hypertension, pre-eclampsia, and eclampsia. Macrosomia and low-birthweight were defined as birthweight >4kg and <2.5kg, respectively. Further data were recorded at the time of discharge from hospital and included neonatal complications (neonatal admission, hypoglycaemia, jaundice) and neonatal death. Neonatal admission was defined as formal admission of the neonate to the special baby unit for observation and/or treatment beyond routine neonatal care. Umbilical cord blood, to estimate serum c-peptide concentration, was obtained at the time of delivery by midwives; samples were immediately centrifuged at study sites, stored on ice, and analysed at the MRC/UVRI & LSHTM Uganda Research Unit central laboratory.