{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:58:28Z","timestamp":1791669508394,"version":"4.3.4"},"reference-count":72,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine the precise relationship between the timing of gestational diabetes mellitus (GDM) diagnosis and adverse maternal, perinatal and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      PubMed, EMBASE, Cochrane Central, Web of Science and CINAHL from inception to March 5, 2026 were systematically searched for observational studies and post hoc analyses or subanalyses of randomised controlled trials comparing outcomes between early\u2010onset GDM (eGDM) and late\u2010onset GDM (LGDM). The tested outcomes included insulin initiation, caesarean delivery, preterm birth, large\u2010for\u2010gestational\u2010age (LGA) infants and neonatal intensive care unit (NICU) admission. Pooled odds ratios (ORs) were calculated using random\u2010effects models. Heterogeneity was assessed using Cochran's\n                      <jats:italic>Q<\/jats:italic>\n                      test and\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic. Meta\u2010regression and subgroup analyses were used to explore the sources of heterogeneity and sensitivity analyses confirmed robustness. The protocol was registered in PROSPERO (CRD420261328602).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010five studies encompassing 105\u2009123 pregnancies met inclusion criteria. eGDM is associated with significantly elevated odds of insulin initiation (OR, 95% CI: 2.26, 1.75\u20132.91), caesarean delivery (1.16, 1.01\u20131.33), preterm birth (1.32, 1.05\u20131.64), LGA (1.29, 1.06\u20131.58) and NICU admission (1.24, 1.03\u20131.50). Heterogeneity is substantial (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200957.3%\u201386.5%). Certainty is rated by GRADE as moderate for preterm birth and low for the other four outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>eGDM versus LGDM is associated with higher risks of adverse outcomes, particularly insulin initiation. Gestational age at diagnosis may serve as a key risk stratifier, highlighting the need for risk\u2010stratified approaches rather than universal early surveillance. Future research should prioritise individual\u2010participant data meta\u2010analyses and randomised trials of tailored protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70982","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T01:46:00Z","timestamp":1781055960000},"page":"7849-7863","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early\u2010Onset Versus Late\u2010Onset Gestational Diabetes Mellitus: A Systematic Review and Meta\u2010Analysis of Maternal, Perinatal and Neonatal Outcomes"],"prefix":"10.1111","volume":"28","author":[{"given":"Guangnan","family":"Mei","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Jiangyin City Hospital of Integrated Traditional Chinese and Western Medicine  Jiangyin Jiangsu People's Republic of 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