Earlier detection of gestational diabetes impacts on medication requirements, neonatal and maternal outcomes

Aim: Gestational diabetes (GD) is a global health concern with significant implications for maternal and neonatal outcomes. This study investigates the association between early GD (eGD) diagnosis (<24 weeks), pharmacotherapy requirements and adverse neonatal outcomes. Materials and Methods: A cohort of 369 pregnant women underwent a 75-g oral glucose tolerance test. Maternal variables, pharmacotherapy prescriptions and neonatal outcomes were analysed employing t-tests, χ2 tests, and logistic regression. A p <.05 was considered significant. Results: Early GD increased the odds of neonatal hypoglycaemia [odds ratio (OR): 18.57, p =.013] and respiratory distress syndrome (OR: 4.75, p =.034). Nutritional therapy prescription by an accredited nutritionist was the most common treatment in women diagnosed after 24 weeks, but those with eGD required more frequently specialized nutritional consulting metformin to achieve glycaemic control (p =.027). eGD was associated with a higher requirement of nutritional therapy prescription metformin (OR: 2.26, 95%25 confidence interval: 1.25-4.09, p =.007) and with maternal hyperglycaemia during the post-partum period at 2 h of the oral glucose tolerance test (OR: 1.03, 95%25 confidence interval: 1.02-1.13, p =.024). Conclusion: Timely diagnosis and personalized treatment of GD are desirable because an earlier presentation is related to a higher risk of adverse neonatal and maternal outcomes.

early diagnosis; gestational diabetes; neonatal complications; perinatal outcomes; pharmacotherapy Adult; Blood Glucose; Cohort Studies; Diabetes, Gestational; Early Diagnosis; Female; Glucose Tolerance Test; Humans; Hypoglycemia; Hypoglycemic Agents; Infant, Newborn; Metformin; Pregnancy; Pregnancy Outcome; Respiratory Distress Syndrome, Newborn; hemoglobin A1c; metformin; antidiabetic agent; metformin; adult; Article; artificial ventilation; blood glucose monitoring; cesarean section; cohort analysis; diabetic obesity; dietitian; early diagnosis; female; gestational age; gestational diabetes; glucose blood level; glucose tolerance; glucose tolerance test; human; insulin sensitivity; lifestyle modification; low birth weight; neonatal hypoglycemia; newborn death; personalized medicine; physical activity; pregnancy outcome; pregnant woman; prevalence; prospective study; blood; diagnosis; drug therapy; epidemiology; gestational diabetes; glucose tolerance test; hypoglycemia; metabolism; neonatal respiratory distress syndrome; newborn; pregnancy; prevention and control

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