{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T23:04:30Z","timestamp":1782169470802,"version":"3.54.5"},"reference-count":79,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Gestational diabetes mellitus (GDM) significantly impacts long-term child health outcomes. This study assessed neonatologists' knowledge, attitudes, and practices (KAP) regarding GDM-related complications in offspring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study of 1,614 neonatologists in Hubei Province, China, utilized a validated 28-item questionnaire examining knowledge (12 items), attitudes (8 items), and practices (8 items). Responses were scored on a trichotomous scale. Binary logistic regression analyzed predictors of satisfactory performance across domains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1,614 neonatologists, 1,437 (89%) demonstrated satisfactory knowledge, 1,513 (94%) positive attitudes, and 1,165 (72%) good practices. Knowledgeable practitioners were significantly older (45.4 vs 36.2 years; OR 1.42 [95% CI 1.40-1.44]; <jats:italic>p<\/jats:italic>&amp;lt;.001) with greater experience (13.8 vs 10.5 years; 1.41 [1.35-1.46]; <jats:italic>p<\/jats:italic>&amp;lt;.001). Academic hospital affiliation showed higher competency versus community settings (0.12 [0.08-0.20]; <jats:italic>p<\/jats:italic>&amp;lt;.001). Practice patterns varied by education, with MD-PhD holders demonstrating higher odds of good practice (1.32 [1.03-1.71]; P=.032) compared with fellowship training (0.69 [0.51-0.92]; <jats:italic>p<\/jats:italic>=.009). Universal documentation of maternal GDM coexisted with suboptimal rates of periodic evaluations (81%) and specialist referrals (84%). Knowledge competency (7.52 [5.90-9.60]; <jats:italic>p<\/jats:italic>&amp;lt;.001) and positive attitudes (15.81 [9.90-25.26]; <jats:italic>p<\/jats:italic>&amp;lt;.001) strongly predicted practice patterns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite high knowledge levels and positive attitudes, particularly among experienced practitioners in academic settings, implementation gaps exist in follow-up protocols and specialist referrals. Practice setting significantly influences care delivery, suggesting the need for standardized protocols across healthcare tiers.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1574480","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T12:26:18Z","timestamp":1751545578000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of neonatologists' competency in managing gestational diabetes complications: a cross-sectional analysis from 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