Diabetes and Adverse Reproductive Outcomes in a Group of Mongolian Women: A Comparative Study with Non-Diabetic Subjects

<b>Background/Objectives:</b> Diabetes mellitus (DM) poses an increasing burden in Mongolia, yet its impact on reproductive outcomes remains underexplored. This study aimed to compare pregnancy outcomes between diabetic and non-diabetic women and assess whether diabetes duration influences adverse reproductive events. <b>Methods:</b> We conducted a cross-sectional study among 223 diabetic and 495 non-diabetic women attending outpatient clinics in Ulaanbaatar between October and December 2024. Data on reproductive history were collected using structured questionnaires. Pregnancy outcomes included miscarriage, stillbirth, abortion, and live birth. Logistic regression models were applied to assess associations, adjusting for age, marital status, education, smoking, alcohol use, age at menarche, and reproductive history. <b>Results:</b> Mean age was 51.7 and 50.4 years for diabetic and non-diabetic women, respectively (<i>p</i> = 0.222). Diabetic women had more pregnancies (median: 4.00 vs. 3.00, <i>p</i> < 0.001) and a higher likelihood of abortion (35.4% vs. 25.5%, <i>p</i> = 0.004) and miscarriage (27.8% vs. 11.1%, <i>p</i> < 0.001). Stillbirths were more frequent in diabetic (4.0% vs. 2.2%) but not statistically significant. Pregnancy problems (miscarriage and/or stillbirth) were more prevalent in diabetic women (29.6% vs. 12.7%, <i>p</i> < 0.001). In adjusted models, diabetes was associated with higher odds of pregnancy problems (aOR = 1.64, 95% CI: 1.02-2.63, <i>p</i> = 0.042), miscarriage (aOR = 2.03, 95% CI: 1.21-3.40, <i>p</i> = 0.007), and abortion (aOR = 1.58, 95% CI: 1.14-2.19, <i>p</i> = 0.006). A dose response pattern was observed: miscarriage risk was higher in women with diabetes ≥10 years (OR = 2.67, 95% CI: 1.55-4.62, <i>p</i> < 0.001) than <10 years (OR = 1.79, 95% CI: 1.08-2.96, <i>p</i> = 0.023). <b>Conclusions:</b> Diabetes is independently associated with increased risks of miscarriage and abortion in Mongolian women, with longer disease duration further elevating this risk.