{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:50:26Z","timestamp":1789487426869,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The timing of gestational diabetes mellitus (GDM) diagnosis may influence maternal and neonatal outcomes, yet the differential impact of early\u2010onset versus late\u2010onset GDM remains incompletely characterized, particularly in Chinese populations. To compare maternal and neonatal outcomes between early\u2010onset GDM (diagnosed before 20\u2009weeks' gestation) and late\u2010onset GDM (diagnosed at 24\u201328\u2009weeks' gestation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 1847 singleton pregnancies complicated by GDM at Qingdao Municipal Hospital from January 2020 to December 2023. Participants were classified into early\u2010onset (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009583) and late\u2010onset (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091264) groups. Primary outcomes included composite adverse neonatal outcome, preeclampsia, and cesarean delivery. Multivariate logistic regression was performed to calculate adjusted odds ratios (aOR) after controlling for maternal age, pre\u2010pregnancy BMI, nulliparity, family history of diabetes, and chronic hypertension.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Women with early\u2010onset GDM demonstrated significantly higher rates of insulin requirement (45.8% vs. 21.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Early\u2010onset GDM was associated with increased risks of preeclampsia (aOR 1.85, 95% CI 1.38\u20132.47), cesarean delivery (aOR 1.84, 95% CI 1.53\u20132.28), and preterm birth (aOR 2.69, 95% CI 2.05\u20133.47). Neonatal complications were substantially elevated in the early\u2010onset group, including macrosomia (aOR 1.86, 95% CI 1.41\u20132.37), neonatal hypoglycemia (aOR 2.04, 95% CI 1.57\u20132.67), respiratory distress (aOR 2.60, 95% CI 1.78\u20133.71), and NICU admission (aOR 2.16, 95% CI 1.69\u20132.74). The composite adverse neonatal outcome occurred in 61.2% of early\u2010onset versus 37.7% of late\u2010onset cases (aOR 2.57, 95% CI 2.13\u20133.15).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early\u2010onset GDM may represent a clinically distinct, higher\u2010risk phenotype with notably elevated maternal and neonatal morbidity compared to late\u2010onset disease. Given the observational design and the potential for residual confounding, these findings should be regarded as hypothesis\u2010generating rather than definitive. They require confirmation in prospective, multicenter studies before risk stratification by diagnostic timing or intensified surveillance can be advocated for routine clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70308","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:24:55Z","timestamp":1784175895000},"page":"2012-2022","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early\u2010 vs. late\u2010onset gestational diabetes: Differential impact on maternal and neonatal outcomes"],"prefix":"10.1111","volume":"105","author":[{"given":"Baolai","family":"Li","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Qingdao Hospital University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)  Qingdao Shandong 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