Early screening for GDM may help avoid obstetric complications

Early-diagnosed gestational diabetes mellitus (GDM) may lead to serious obstetric complications, underscoring a need for early screening, according to a recent Japan study.

Drawing from the Japan Environment and Children’s Study, researchers retrieved data of 100,376 singleton pregnancies. Participants were divided into three groups: no-GDM controls (n=98,090) and early (<24 weeks of gestation; n=751) and late (>24 weeks of gestation; n=1,535) GDM diagnosis. For the remaining 274 GDM patients, the timing of diagnosis was unknown.

Preterm birth, defined as either delivery <37 weeks (p=0.003) or <34 weeks (p=0.015) of gestation, occurred most commonly among mothers diagnosed early with GDM. The same was true for low infant birth weight, whether defined as <2,500 g (p=0.021) or <1,500 g (p<0.001). Hypertensive disorders of pregnancy and caesarean section delivery were also significantly more common in the early diagnosis group.

Multiple logistic regression model analyses found that early diagnosis of GDM significantly increased the overall risk of developing hypertensive disorders of pregnancy (adjusted odds ratio [aOR], 2.08, 95 percent confidence interval [CI], 1.51–2.58), as well as its early- and late-onset forms. Similarly, early diagnosis raised the likelihood of needing caesarean section (aOR, 1.34, 95 percent CI, 1.13–1.59).

Notably, late GDM diagnosis likewise had a similar effect on caesarean section and hypertensive disorders of pregnancy, while also exacerbating the risks of preterm birth and giving birth to low-for-gestational age infants.

“The findings of our study provide validation for early screening for GDM because early-diagnosis GDM was found to be associated with adverse obstetric outcomes. Further studies considering the time of GDM onset are warranted,” the researchers said.