{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:17:43Z","timestamp":1793409463159,"version":"4.5.0"},"reference-count":26,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Gestational diabetes mellitus (GDM) is known to be associated with pregnancy complications but there is limited evidence about the strength of these associations in recent clinical practice, especially after the introduction of strict guidelines for the management of pregnancies with GDM in a multidisciplinary team setting. The objectives of our study were to first compare the rates of complications in pregnancies with GDM with those that had pre-existing diabetes mellitus and those without diabetes; and second, to derive measures of effect size expressed as odds ratios after adjustment for confounding factors to assess the independent association of GDM in prediction of these pregnancy complications. Materials and Methods: This was a prospective cohort study undertaken at a large maternity unit in the United Kingdom between January 2010 and June 2022. We included singleton pregnancies that were booked at our unit at 11\u201313 weeks\u2019 gestation. Multivariate regression analysis was carried out to determine the risks of complications in pregnancies with GDM after adjusting for pregnancy characteristics. Risks were expressed as odds ratio (OR) (95% confidence intervals [CI]) and expressed graphically in forest plots. Results: The study population included 53,649 singleton pregnancies including 509 (1%) with pre-existing DM, 2089 (4%) with GDM and 49,122 (95%) pregnancies without diabetes. Multivariate regression analysis demonstrated that there was a significant independent contribution from GDM in the prediction of adverse outcomes, including maternal complications such as preterm delivery, polyhydramnios, preeclampsia and delivery of large for gestational age neonates and elective caesarean section (CS); and neonatal complications including admission to neonatal intensive care unit, hypoglycaemia, jaundice and respiratory distress syndrome. Conclusions: GDM is associated with an increased rate of pregnancy complications compared to those without diabetes, even after adjustment for maternal and pregnancy characteristics. GDM does not increase the risk of stillbirth, hypoxic ischaemic encephalopathy or neonatal death.<\/jats:p>","DOI":"10.3390\/medicina59122096","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T09:00:18Z","timestamp":1701248418000},"page":"2096","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Gestational Diabetes Mellitus: Association with Maternal and Neonatal Complications"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7312-1397","authenticated-orcid":false,"given":"Rebecca","family":"Karkia","sequence":"first","affiliation":[{"name":"Medway Fetal and Maternal Medicine Centre, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8434-6815","authenticated-orcid":false,"given":"Tara","family":"Giacchino","sequence":"additional","affiliation":[{"name":"Medway Fetal and Maternal Medicine Centre, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saadia","family":"Shah","sequence":"additional","affiliation":[{"name":"Women\u2019s Care Group, Department of Obstetrics, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Gough","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0753-3817","authenticated-orcid":false,"given":"Ghada","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Oliver Fisher Neonatal Unit, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-5442","authenticated-orcid":false,"given":"Ranjit","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Medway Fetal and Maternal Medicine Centre, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"},{"name":"Women\u2019s Care Group, Department of Obstetrics, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK"},{"name":"Institute of Medical Sciences, Canterbury Christ Church University, Chatham, Kent ME4 4UF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Committee on Practice Bulletins\u2014Obstetrics Practice Bulletin No (2017). 180: Gestational Diabetes Mellitus. 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