Maternal and Fetal–Neonatal Complications of Romanian Women with Gestational Diabetes: A Retrospective Comparative Study

<i>Background and Objectives:</i> Gestational diabetes mellitus (GDM) is a complex condition characterized by metabolic disorders of blood glucose that significantly impact the health of both mother and fetus. The objectives of this study were to assess the prevalence and risk factors for maternal and fetal-neonatal complications in women with GDM, comparing them to a control group (pregnant women without GDM) and pregnant women with type 1 diabetes mellitus (T1DM) or type 2 diabetes (T2DM). <i>Materials and Methods:</i> A retrospective observational study was conducted with 1418 pregnant women (279 with GDM, 74 with T1DM, 107 with T2DM, and 958 in the control group). The retrospective data included information on demographics, diagnostic test results, the medical history of pregnant women, treatments administered, identified complications, and other relevant variables for the study's purpose. <i>Results:</i> Significant differences were found regarding maternal and neo-fetal complications between GDM and the control group in terms of abortion, pregnancy-induced hypertension, and increased fetal weight (macrosomia). Women with T1DM and T2DM showed a higher rate of abortion, premature birth, and an APGAR score of <7 at 5 min compared to those with GDM, and for T1DM, there was a higher rate of fetal mortality than in GDM cases. The primary risk factors for maternal complications included age OR = 1.03 (95% CI: 1.01-1.05, <i>p</i> = 0.002), obesity OR = 2.37 (95% CI: 1.42-3.94, <i>p</i> < 0.001), and chronic hypertension OR = 2.51 (95% CI: 1.26-5.01, <i>p</i> = 0.009). Age and obesity were also significant cofactors for maternal complications. Furthermore, the main significant risk factors for fetal-neonatal complications were obesity OR = 2.481 (95% CI:1.49-4.12, <i>p</i> < 0.001) and chronic hypertension OR = 2.813 (95% CI:1.44-5.49, <i>p</i> = 0.002), both independently and as cofactors. <i>Conclusions:</i> We found that obesity and chronic hypertension are risk factors for both maternal and fetal-neonatal complications. It is essential to prevent and adequately treat these two factors among pregnant women to avoid the onset of GDM. Additionally, screening for GDM is necessary to prevent maternal and fetal complications. Our results highlight the importance of specialized medical care and tailored management protocols in mitigating risks and ensuring positive outcomes for both mother and child during and after childbirth.