Early-Onset Gestational Diabetes Tied to Higher Risk of Preterm Birth and Low Birth Weight, Study Finds
India: A new study published in the International Journal of Gynecology and Obstetrics has highlighted that early-onset gestational diabetes mellitus (EGDM), diagnosed before 24 weeks of pregnancy, is associated with adverse maternal and neonatal outcomes among South Indian women.
The research, led by Dr. Haritha Sagili from the Department of Obstetrics and Gynaecology at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, emphasizes the importance of timely screening and close monitoring of women diagnosed early in pregnancy.
The retrospective cohort study included 2,401 singleton pregnancies in women aged over 18 years diagnosed with gestational diabetes mellitus (GDM) based on the International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria. The participants were categorized into two groups: early gestational diabetes mellitus (EGDM), diagnosed before 24 weeks, and late gestational diabetes mellitus (LGDM), diagnosed at or after 24 weeks of gestation.
Key Findings:
- Among 2,401 participants, 482 women had early gestational diabetes mellitus (EGDM), while 1,919 had late gestational diabetes mellitus (LGDM).
- Women with EGDM had a higher mean maternal age (28.5 vs. 27.5 years), greater prevalence of obesity (body mass index ≥25 kg/m²), and fewer years of education compared to those with LGDM.
- The rate of spontaneous conception was lower in the EGDM group (93.2%) compared with the LGDM group (96.7%).
- Women diagnosed early required more pharmacotherapy, with a higher need for combined insulin and metformin therapy (12% vs. 3.2%; adjusted relative risk [aRR] 2.19).
- The use of metformin alone was also more frequent among EGDM women (35.9% vs. 18.5%; aRR 1.85).
- EGDM was associated with a higher risk of preterm birth (aRR 2.25) and an increased likelihood of low birth weight infants (aRR 1.35).
According to the authors, these findings suggest that women diagnosed with GDM early in pregnancy tend to have a more adverse metabolic profile, increasing their risk of complications despite timely management. Early hyperglycemia may reflect more severe underlying glucose intolerance or undiagnosed pregestational diabetes, which could contribute to poorer fetal growth and development.
The researchers emphasized the need for heightened vigilance, personalized treatment approaches, and regular follow-up for women identified with EGDM to mitigate adverse outcomes. They also noted that the study highlights the potential value of universal screening for GDM in early pregnancy, especially in high-risk populations such as Asian Indians, who are predisposed to insulin resistance and metabolic disorders.
"The study reinforces that early-diagnosed gestational diabetes mellitus is not just an earlier version of late-onset GDM but a distinct clinical entity with a higher risk profile. Early detection, prompt intervention, and close obstetric monitoring are crucial to improving both maternal and neonatal outcomes in this vulnerable group," the authors concluded.
Reference:
Sagili, H., Rajandran, P., Kuruvilla, A., Duraiswamy, M., Keepanasseril, A., Plakkal, N., Nair, S., Mohan, V., & Kamalanathan, S. Early gestational diabetes mellitus versus late gestational diabetes mellitus: Maternal and neonatal outcomes in a retrospective cohort in Asian Indians. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.70568
Next Story