International Journal of Reproductive BioMedicine
ISSN: 2476-3772
The latest discoveries in all areas of reproduction and reproductive technology.
Gestational diabetes mellitus: Major risk factors and pregnancy-related outcomes: A cohort study
Published date: Oct 10 2021
Journal Title: International Journal of Reproductive BioMedicine
Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 19, Issue No. 9
Pages: 827 - 836
Authors:
Abstract:
Background: Gestational diabetes mellitus (GDM) is a major pregnancy endocrine problem that has several confirmed risk factors and is associated with adverse pregnancy-related outcomes (PRO).
Objective: To evaluate the relationship between GDM diagnosis and the associated risk factors of PRO (maternal, intrapartum, perinatal, and neonatal) in accordance with International Association of Diabetes and Pregnancy Study Groups criteria.
Materials and Methods: This prospective cohort study was performed with 531 singleton parturient (265 GDM and 266 non-GDM). They were selected consecutively from referral hospitals, and the maternal, intrapartum, perinatal, and neonatal outcomes were assessed.
Results: The major risk factors influencing the GDM diagnosis were maternal age, obesity, family history of diabetes, previous history of GDM, and previous history of macrosomia. In the comparison of PRO between the groups, significant associations were detected for emergency cesarean delivery, preeclampsia, polyhydramnios, premature rupture of membrane, preterm delivery, and neonatal hyperbilirubinemia in the GDM group. In the multivariate logistic regression analysis, a previous history of stillbirth was significantly associated with maternal and perinatal outcomes. The odds ratios (CI 95%) of the PRO in the women with a GDM diagnosis were: maternal = 2.43 (1.51-3.90), intrapartum = 2.05 (1.35- 3.11), perinatal = 2.00 (1.29-3.10), and neonatal = 1.68 (1.08-2.62). The PRO was significantly correlated with GDM diagnosis, but not with the risk factors.
Conclusion: The adverse pregnancy outcomes were significantly correlated with GDM diagnosis, and the outcomes were not directly affected by the risk factors. Given the related adverse outcomes for mothers and offspring, early screening and management of GDM is necessary especially in Asians and in low-/middle-income countries.
Key words: Gestational diabetes mellitus, Pregnancy outcomes, Risk factors.
References:
[1] Jafari-Shobeiri M, Ghojazadeh M, Azami-Aghdash S, Naghavi-Behzad M, Piri R, Pourali-Akbar Y, et al. Prevalence and risk factors of gestational diabetes in Iran: A systematic review and meta-analysis. Iran J Public Health 2015; 44: 1036–1044.
[2] Logakodie S, Azahadi O, Fuziah P, Norizzati B, Tan SF, Zienna Z, et al. Gestational diabetes mellitus: The prevalence, associated factors and foeto-maternal outcome of women attending antenatal care. Malays Fam Physician 2017; 12: 9–17.
[3] Miao M, Dai M, Zhang Y, Sun F, Guo X, Sun G. Influence of maternal overweight, obesity and gestational weight gain on the perinatal outcomes in women with gestational diabetes mellitus. Sci Rep 2017; 7: 305.
[4] Erem C, Kuzu UB, Deger O, Can G. Prevalence of gestational diabetes mellitus and associated risk factors in Turkish women: The trabzon GDM study. Arch Med Sci 2015; 11: 724–735.
[5] Lowe Jr WL, Scholtens DM, Kuang A, Linder B, Lawrence JM, Lebenthal Y, et al. Hyperglycemia and adverse pregnancy outcome follow-up study (HAPO FUS): Maternal gestational diabetes mellitus and childhood glucose metabolism. Diabetes Care 2019; 42: 372–380.
[6] International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan ThA, Catalano PA, et al. International Association of Diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33: 676–682.
[7] Sayehmiri F, Bakhtiyari S, Darvishi P, Sayehmiri K. [Prevalence of gestational diabetes mellitus in Iran: A systematic review and meta-analysis study]. The Iranian Journal of Obstetrics, Gynecology and Infertility 2013; 15: 16–23. (in Persian)
[8] Alijahan R, Hazrati S, Mirzarahimi M, Pourfarzi F, Ahmadi Hadi P. Prevalence and risk factors associated with preterm birth in Ardabil, Iran. Iran J Reprod Med 2014; 12: 47–56.
[9] Henriksen T. The macrosomic fetus: A challenge in current obstetrics. Acta Obstet Gynecol Scand 2008; 87: 134–145.
[10] Fischer C, Rybakowski C, Ferdynus C, Sagot P, Gouyon JB. A population-based study of meconium aspiration syndrome in neonates born between 37 and 43 weeks of gestation. Int J Pediatr 2011; 2012: 321545.
[11] Hossein-nezhad A, Mirzaei Kh, Ahmadi S, Maghbooli Zh, Karimi F. Comparison of incidence of pregnancy induced hypertension in gestational diabetes mellitus and healthy pregnant women. Iranian Journal of Diabetes and Lipid Disorders 2011; 10: 1–9.
[12] Krukowski RA, West DS, DiCarlo M, Shankar K, Cleves MA, Saylors ME, et al. Are early first trimester weights valid proxies for preconception weight? BMC Pregnancy Childbirth 2016; 16: 357.
[13] American Diabetes Association. 2. Classification and diagnosis of diabetes. Diabetes Care 2015; 38 (Suppl.): S8–S16.
[14] Metzger BE, Buchanan ThA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, et al. Summary and recommendations of the fifth international workshopconference on gestational diabetes mellitus. Diabetes Care 2007; 30 (Suppl.): S251–S260.
[15] ACOG Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin. diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. Obstet Gynecol 2002; 99: 159–167.
[16] Adamkin DH. Neonatal hypoglycemia. Semin Fetal Neonat Med 2017; 22: 36–41.
[17] Pichon JBL, Riordan SM, Watchko J, Shapiro SM. The neurological sequelae of neonatal hyperbilirubinemia: Definitions, diagnosis and treatment of the kernicterus spectrum disorders (KSDs). Curr Pediatr Rev 2017; 13: 199– 209.
[18] Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 update. Neonatology 2013; 103: 353–368.
[19] Kampmann U, Madsen LR, Skajaa GO, Iversen DS, Moeller N, Ovesen P. Gestational diabetes: A clinical update. World J Diabetes 2015; 6: 1065–1072.
[20] Jenum AK, Sommer Ch, Sletner L, Mørkrid K, Bærug A, Mosdøl A. Adiposity and hyperglycaemia in pregnancy and related health outcomes in European ethnic minorities of Asian and African origin: A review. Food Nutr Res 2013; 57: 18889.
[21] Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YCh, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: A systematic review and metaanalysis. BMC Pregnancy Childbirth 2018; 18: 494.
[22] Avalos GE, Owens LA, Dunne F, Collaborators AD. Applying current screening tools for gestational diabetes mellitus to a European population: Is it time for change? Diabetes Care 2013; 36: 3040–3044.
[23] Keshavarz M, Cheung NW, Babaee GhR, Kalalian Moghadam H, Ajami ME, Shariati M. Gestational diabetes in Iran: Incidence, risk factors and pregnancy outcomes. Diabetes Res Clin Pract 2005; 69: 279–286.
[24] Jolly M, Sebire N, Harris J, Robinson S, Regan L. The risks associated with pregnancy in women aged 35 years or older. Hum Reprod 2000; 15: 2433–2437.
[25] Korkmazer E, Solak N. Correlation between inflammatory markers and insulin resistance in pregnancy. J Obstet Gynaecol 2015; 35: 142–145.
[26] Nilofer AR, Raju VS, Dakshayini BR, Zaki SA. Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes. Indian J Endocrinol Metab 2012; 16 (Suppl.): S74–S78.
[27] Rajput R, Yadav Y, Nanda S, Rajput M. Prevalence of gestational diabetes mellitus & associated risk factors at a tertiary care hospital in Haryana. Indian J Med Res 2013; 137: 728–733.
[28] Fitria N, van Asselt ADI, Postma MJ. Cost-effectiveness of controlling gestational diabetes mellitus: A systematic review. Eur J Health Econ 2019; 20: 407–417.
[29] Kamana K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: A literature review. Ann Nutr Metab 2015; 66 (Suppl.): 14–20.
[30] Young BC, Ecker JL. Fetal macrosomia and shoulder dystocia in women with gestational diabetes: Risks amenable to treatment? Curr Diab Rep 2013; 13: 12–18.
[31] Metzger BE, Persson B, Lowe LP, Dyer AR, Cruickshank JK, Deerochanawong Ch, et al. Hyperglycemia and adverse pregnancy outcome study: Neonatal glycemia. Pediatrics 2010; 126: e1545–e1552.
[32] Opara PI, Jaja T, Onubogu UC. Morbidity and mortality amongst infants of diabetic mothers admitted into a special care baby unit in Port Harcourt, Nigeria. Ital J Pediatr 2010; 36: 77.
29
Nina Meloncelli, Shelley A. Wilkinson, Alita Rushton, Kelsey Pateman, Sam Gallaher, Hannah O'Connor, Lauren Kearney, Susan de Jersey (2024)
Co‐designing The Healthy Gut Diet for Preventing Gestational Diabetes: Co‐design methods and process outcomes, Journal of Human Nutrition and DieteticsVolume: 37, Issue: 5, First Page: 1231
10.1111/jhn.13341
A. O. Veys, O. N. Novikova (2025)
Current perspectives on risk factors for premature rupture of membranes, Fundamental and Clinical MedicineVolume: 10, Issue: 2, First Page: 56
10.23946/2500-0764-2025-10-2-56-66
Zhiying Song, Shumin Li, Rongqin Li, Colleen Kiernan (2022)
An Investigation into the Correlation of Intestinal Flora with Obesity and Gestational Diabetes Mellitus, Computational and Mathematical Methods in MedicineVolume: 2022, First Page: 1
10.1155/2022/5677073
Ionescu Gabriela, Marina Nicolae-Gabriel, Scurtu Francesca, Dorneanu Denisa, Edu Mihnea-Dan, Mateescu Radu-Nicolae, Mihaela Plotogea, Antoine Edu, Claudia Mehedinţu, Noditi Aniela (2024)
Efectele placentare ale rezistenţei la insulină în sarcinile complicate cu diabet zaharat gestaţional, Obstetrica şi GinecologiaVolume: 2, Issue: 73, First Page: 74
10.26416/ObsGin.72.2.2024.9716
Dhruvil Gajera, Vishva Trivedi, Priyanshu Thaker, Mrudang Rathod, Abhay Dharamsi (2023)
Detailed Review on Gestational Diabetes Mellitus with Emphasis on Pathophysiology, Epidemiology, Related Risk Factors, and its Subsequent Conversion to Type 2 Diabetes Mellitus, Hormone and Metabolic ResearchVolume: 55, Issue: 05, First Page: 295
10.1055/a-2061-9441
Sinem Tekin, Aydın Ocal, Filiz Yarsilikal Guleroglu, Cagseli Göksu Ozgün Selcuk, Omer Gökhan Eyisoy, Emine Ufuk Büyükkaya Ocal, Ali Cetin (2025)
Prediction of gestational diabetes mellitus using clinical and ultrasonographic parameters: development of independent maternal and fetal models, Journal of Perinatal MedicineVolume: 53, Issue: 8, First Page: 1062
10.1515/jpm-2025-0135
Chang Zou, Qinxin Shen, Yuanyuan Yang, Yini Liao, Qiaoling Du (2025)
Association of maternal thyroid function and gestational diabetes with pregnancy outcomes: a retrospective cohort study, Frontiers in EndocrinologyVolume: 16
10.3389/fendo.2025.1555409
Watip Tangjittipokin, Tassanee Narkdontri, Nipaporn Teerawattanapong, Benyapa Thanatummatis, Fauchil Wardati, Prasert Sunsaneevithayakul, Dittakarn Boriboonhirunsarn (2023)
The Variants in ADIPOQ are Associated with Maternal Circulating Adipokine Profile in Gestational Diabetes Mellitus, Journal of Multidisciplinary HealthcareVolume: Volume 16, First Page: 309
10.2147/JMDH.S396238
Minhua Jiang, Renhong Sui, Xiaoqing Wu (2024)
Association between sleep quality and duration during pregnancy and risk of gestational diabetes: A systematic review and meta-analysis, Gynecological EndocrinologyVolume: 40, Issue: 1
10.1080/09513590.2024.2391925
Yuan Gao, Min Zhou, Xuan Xu, Jun Yang Ma, Man Fen Qin (2024)
Body composition and risk of gestational diabetes mellitus: A univariable and multivariable Mendelian randomization study, Journal of Diabetes InvestigationVolume: 15, Issue: 3, First Page: 346
10.1111/jdi.14115
Vidyasri Bailore, Kalpana Basany, Maheshwari Banda (2024)
Adverse pregnancy outcomes with respect to treatment modalities in women with gestational diabetes mellitus at a rural tertiary care teaching hospital, Journal of Family Medicine and Primary CareVolume: 13, Issue: 8, First Page: 2986
10.4103/jfmpc.jfmpc_1495_23
Pei-Qi Lim, Yen-Ju Lai, Pei-Ying Ling, Kuo-Hu Chen (2023)
Cellular and molecular overview of gestational diabetes mellitus: Is it predictable and preventable?, World Journal of DiabetesVolume: 14, Issue: 11, First Page: 1693
10.4239/wjd.v14.i11.1693
Stephanie Anderson, Jacinta Perram, Anna Nelson, Stephen Matthews, Mel Gou, P. Joy Ho (2024)
Pregnancy and assisted reproductive technology use in Australian female transfusion‐dependent haemoglobinopathy patients: a 20‐year retrospective analysis, Internal Medicine JournalVolume: 54, Issue: 2, First Page: 290
10.1111/imj.16169
Jwan Ibrahim Jawzali, Sahar Ismail Abdullah, Nahidah Hassan Abdullah (2022)
Nutritional status among pregnant adolescents at maternity teaching hospital, The North African Journal of Food and Nutrition ResearchVolume: 6, Issue: 14, First Page: 186
10.51745/najfnr.6.14.186-197
Wei-Li Cao, Cui-Ping Yu, Ling-Li Zhang (2024)
Serum proteins differentially expressed in gestational diabetes mellitus assessed using isobaric tag for relative and absolute quantitation proteomics, World Journal of Clinical CasesVolume: 12, Issue: 8, First Page: 1395
10.12998/wjcc.v12.i8.1395
Aleesha Asghar, Sabika Firasat, Kiran Afshan, Shagufta Naz (2023)
Association of CDKAL1 gene polymorphism (rs10946398) with gestational diabetes mellitus in Pakistani population, Molecular Biology ReportsVolume: 50, Issue: 1, First Page: 57
10.1007/s11033-022-08011-x
Xiaojun Fan (2024)
Improved pregnancy outcome in gestational diabetes mellitus patients treated with insulin aspart and metformin: a comparative study, American Journal of Translational ResearchVolume: 16, Issue: 4, First Page: 1177
10.62347/NIGM4906
Dong Gao, Liping Ren, Yu-Duo Hao, Nalini Schaduangrat, Xiao-Wei Liu, Shi-Shi Yuan, Yu-He Yang, Yan Wang, Watshara Shoombuatong, Hui Ding (2023)
The role of ncRNA regulatory mechanisms in diseases—case on gestational diabetes, Briefings in BioinformaticsVolume: 25, Issue: 1
10.1093/bib/bbad489
David Haas, Hani Faysal, MItchell Grecu, Kathleen M Flannery, Haley Schmidt, Maha Aamir, Rafael Guerrero, Chia-Fang Chung, Constantine Scordalakes, Brennan Fitzpatrick, Shelley Dowden, Shannon Barnes, David Guise, Aric J Kotarski, Chandan Saha, Predrag Radivojac, Christina Scifres, Katherine Connelly (2024)
Early pregnancy associations with Gestational Diabetes: methods and cohort results of the Hoosier Moms Cohort, North American Proceedings in Gynecology & ObstetricsVolume: 3, Issue: 3
10.54053/001c.121481
Agnesa Preda, Dominic-Gabriel Iliescu, Alexandru Comănescu, George-Lucian Zorilă, Ionela Mihaela Vladu, Mircea-Cătălin Forțofoiu, Tiberiu Stefaniță Țenea-Cojan, Silviu-Daniel Preda, Ileana-Diana Diaconu, Eugen Moța, Ioan-Ovidiu Gheorghe, Maria Moța (2023)
Gestational Diabetes and Preterm Birth: What Do We Know? Our Experience and Mini-Review of the Literature, Journal of Clinical MedicineVolume: 12, Issue: 14, First Page: 4572
10.3390/jcm12144572
Shujuan Liao, Anqi Xiong, Siqi Xiong, Yan Zuo, Yan Wang, Biru Luo (2025)
Associations between maternal body composition in the second trimester and premature rupture of membranes: a retrospective study using hospital information system data, BMC Pregnancy and ChildbirthVolume: 25, Issue: 1
10.1186/s12884-025-07334-4
Mohamed A. Mukhtar, Ashwag H. Abdelmajed, Ahmed A. Alamin, Mohammed Ali, Marwa M. Babikir, Mosab Tifoor, Nihal E. Elsheikh, Ezaldeen H. Omer, Nisreen G. Mohammed, Sara M. Abdelgadir, Mohamed E. Ibrahim, Mozdaher G. Ali, Ahmed M. Shamas, Ahmed U. Ahmed, Hana A. Mohamed, Hiba A. Osman, Abdullah I. Aedh (2025)
Prevalence and risk factors of gestational diabetes mellitus among pregnant women in Saudi Arabia: a cross-sectional study, International Journal Of Community Medicine And Public Health
10.18203/2394-6040.ijcmph20251417
Saheed A. Adekola, Dorcas Jolaoluwa Adefoluke, Arinola Makinde, Abdulahi M. Zeberu, Adekola Dhikroh Oriyomi, Nkiru I. Enemuo, Victor O. Ojedapo (2024)
Gestational Diabetes Mellitus Among Women Accessing Antenatal Care at The Federal Medical Centre Ebute Metta, Southwestern Nigeria, Scientia MedicaVolume: 34, Issue: 1, First Page: e45010
10.15448/1980-6108.2024.1.45010
Jacqueline Andrea Moreno Maza, Susana Janeth Peña Cordero (2023)
Prevalencia y factores de riesgo de la diabetes mellitus en el embarazo: una revisión sistemática, AlfaPublicacionesVolume: 5, Issue: 1.1, First Page: 107
10.33262/ap.v5i1.1.322
Muhammad Faisal Javaid, . Azra, Sadiq Jan, Fauzia Sadiq, Tehmeena Munawar, Naveeda Nawaz (2025)
Increased First Trimester Serum Uric Acid as A Predictor of Gestational Diabetes Mellitus, Pakistan Journal of Health SciencesFirst Page: 121
10.54393/pjhs.v6i3.2692
Xiaomei Lv, Yujun An (2024)
Bioinformatics-based Identification of Ferroptosis-related Genes and their Diagnostic Value in Gestational Diabetes Mellitus, Endocrine, Metabolic & Immune Disorders - Drug TargetsVolume: 24, Issue: 14, First Page: 1611
10.2174/0118715303275367240103102801
Komal Aggarwal, Rohit Ravi (2025)
Effect of Gestational Diabetes Mellitus on Newborn Hearing: A Systematic Review, Annals of Otology, Rhinology & LaryngologyVolume: 134, Issue: 2, First Page: 87
10.1177/00034894241287014
Tanu Gautam, Amreen Shamsad, Renu Singh, Monisha Banerjee (2025)
Emerging biomarkers for gestational diabetes mellitus and related pediatric outcomes, World Journal of Clinical PediatricsVolume: 14, Issue: 4
10.5409/wjcp.v14.i4.109476
Cong Minh Nguyen, Mohamed Sallam, Md Sajedul Islam, Kimberley Clack, Narshone Soda, Nam-Trung Nguyen, Muhammad J. A. Shiddiky (2023)
Placental Exosomes as Biomarkers for Maternal Diseases: Current Advances in Isolation, Characterization, and Detection, ACS SensorsVolume: 8, Issue: 7, First Page: 2493
10.1021/acssensors.3c00689
