Complications and risk factors of early-onset versus late-onset gestational diabetes mellitus: A cohort study from Saudi Arabia

• Published in: Saudi medical journal Vol. 44; no. 7; pp. 703 - 710
• Main Authors: Alsulami, Salhah S, Ghamri, Kholoud A
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Saudi Medical Journal 01.07.2023
• Subjects: Cohort Studies; Complications and side effects; Diabetes in pregnancy; Diabetes Mellitus, Type 2; Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Female; Humans; Infant, Newborn; Insulin; Pre-Eclampsia - epidemiology; Pre-Eclampsia - etiology; Pregnancy; Risk Factors; Saudi Arabia - epidemiology; Statistics; Saudi Arabia; cohort study; early onset; maternal complications; pre-eclampsia; gestational diabetes mellitus; late onset; macrosomia
• ISSN: 0379-5284; 1658-3175
• DOI: 10.15537/smj.2023.44.7.20230193

To contribute to this discussion by comparing the complications associated with early-diagnosed versus (vs.) late-diagnosed gestational diabetes mellitus (GDM) for mothers and infants in order to provide baseline data that might guide future changes in the current recommendations for screening. The study compares the risk factors and complications for early- vs. late-diagnosed GDM in a cohort from Saudi Arabia. Prenatal, perinatal, postpartum, and neonatal variables were compared between the early vs. late-diagnosed GDM groups using information gathered from the patient's hospital records. Significant predictors of early-diagnosed GDM included pregestational BMI and GDM history. Additionally, early diagnosis of GDM was linked to a higher incidence of pre-eclampsia and intrauterine fetal death. Women with early-diagnosed GDM also required more glycemic control interventions, like administering insulin and metformin and controlling their diet. The fetal birth weight and postpartum BMI were significantly higher in the early onset GDM group. The need for insulin and pre-eclampsia were significant factors linked to an early diagnosis of GDM, according to a logistic regression analysis. Therefore, the current findings emphasize the need for early screening in pregnant women with high pregestational BMI and a history of GDM and show that those with early-onset GDM more likely to need insulin therapy and be at a higher risk of developing pre-eclampsia.