Abnormal fasting glucose levels in the diagnosis of GDM may be associated with adverse pregnancy outcomes

Arch Gynecol Obstet. 2026 Jan 15;313(1):44. doi: 10.1007/s00404-025-08266-2.

Abstract

Background: Gestational Diabetes Mellitus (GDM) presents significant risks to both maternal and foetal health during pregnancy.

Purpose: This observational study aimed to investigate the association between clinical parameters and adverse pregnancy outcomes in women with GDM.

Methods: A cohort of 2174 GDM-diagnosed women was analysed, with 1705 experiencing no adverse outcomes and 469 developing complications such as preeclampsia, large for gestational age (LGA) infants, preterm birth, and shoulder dystocia. Clinical data, including maternal age, glucose levels, gestational age, body mass index (BMI), and treatment methods, were collected and analysed.

Results: Advanced maternal age, higher parity, increased weekly weight gain, and abnormal fasting glucose levels were associated with adverse pregnancy outcomes in women with GDM. In particular, early onset of GDM, elevated weekly weight gain, and abnormal fasting glucose levels were linked to an increased risk of developing preeclampsia and delivering LGA infants. However, no significant associations were found regarding shoulder dystocia. Furthermore, maternal age and weekly weight gain were identified as risk factors for preterm birth.

Conclusion: This study shows that in addition to well-known risk factors, abnormal fasting glucose levels are significantly linked to developing adverse pregnancy outcomes in women with GDM. Our data suggested that close monitoring of fasting glucose levels and controlling weight gain may significantly reduce the risk of adverse outcomes in pregnancies complicated by GDM.

Keywords: Adverse pregnancy outcomes; Gestational diabetes mellitus; OGTT; Onset of GDM.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Blood Glucose* / analysis
  • Blood Glucose* / metabolism
  • Body Mass Index
  • Diabetes, Gestational* / blood
  • Diabetes, Gestational* / diagnosis
  • Fasting / blood
  • Female
  • Fetal Macrosomia / epidemiology
  • Fetal Macrosomia / etiology
  • Gestational Age
  • Gestational Weight Gain
  • Humans
  • Infant, Newborn
  • Maternal Age
  • Parity
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / etiology
  • Pregnancy
  • Pregnancy Outcome*
  • Premature Birth / epidemiology
  • Premature Birth / etiology
  • Retrospective Studies
  • Risk Factors
  • Shoulder Dystocia / epidemiology
  • Shoulder Dystocia / etiology
  • Weight Gain

Substances

  • Blood Glucose