Maternal and Fetal Complications Associated With Gestational Diabetes Mellitus in a Nicaraguan Tertiary Care Hospital: A Cross-Sectional Study

Introduction Gestational diabetes mellitus (GDM) is a growing public health concern associated with significant maternal and fetal morbidity. Despite global advancements in diagnosis and management, outcomes in low-resource settings such as Nicaragua remain poorly characterized. This study aimed to evaluate the prevalence of maternal and fetal complications associated with GDM and identify factors related to adverse outcomes in a tertiary care hospital in Nicaragua. Methods A cross-sectional study was conducted at Bertha Calderón Roque Women's Teaching Hospital in Managua, Nicaragua, from September 1 to December 31, 2017. Seventy women diagnosed with GDM were included through non-random convenience sampling. Data were extracted from clinical records. Descriptive statistics summarized sociodemographic and clinical variables. Exact logistic regression was used to assess associations between maternal factors and adverse outcomes. Results Maternal complications occurred in 63% of patients, including preeclampsia (31.4%) and emergency cesarean section (40%). Fetal complications included fetal distress (27.1%) and macrosomia (24.3%). Exact logistic regression identified obesity as significantly associated with cesarean delivery (OR = 3.12, 95% CI: 1.18-8.43, p = 0.021) and preeclampsia (OR = 3.56, 95% CI: 1.24-10.53, p = 0.018). Advanced maternal age (>30 years) was associated with cesarean delivery (OR = 4.21, 95% CI: 1.52-12.14, p = 0.006). Fewer prenatal visits (less than four) were associated with cesarean delivery (OR = 3.97, 95% CI: 1.20-14.33, p = 0.024), preeclampsia (OR = 3.88, 95% CI: 1.22-12.93, p = 0.022), fetal distress (OR = 3.45, 95% CI: 1.07-11.63, p = 0.038), and macrosomia (OR = 3.22, 95% CI: 1.01-10.94, p = 0.048). Although individual complications were common, 98.6% of mother-infant pairs had favorable overall clinical outcomes without severe maternal or neonatal morbidity. Conclusions Women with GDM in Nicaragua experience high rates of maternal and neonatal complications, associated with potentially modifiable factors, including obesity, inadequate prenatal care, and advanced maternal age. These findings suggest a need for enhanced screening, improved antenatal coverage, and national clinical guidelines adapted to resource-limited settings.