Gestational Diabetes and Preeclampsia in Adolescent Pregnancy: Neonatal and Obstetric Outcomes

Background: Adolescent pregnancies complicated by gestational diabetes mellitus (GDM) or preeclampsia represent high-risk scenarios with understudied perinatal implications. Objectives: To evaluate and compare the impact of gestational diabetes mellitus and preeclampsia on neonatal and obstetric outcomes among pregnant adolescents in a prospective cohort from Baghdad. Methods: This 6-year prospective cohort study (2019–2025) enrolled 461 pregnant adolescents (≤19 years) stratified into gestational diabetes (GDM) (n=143), preeclampsia (n=157), and healthy controls (n=161). Outcomes were compared separately: GDM vs controls and preeclampsia vs controls using ANOVA, chi-square tests, and multivariate logistic regression. Results: Versus controls, preeclampsia showed higher preterm birth (aOR=7.1; 95% CI:3.6–14.2), cesarean delivery (aOR=4.6; 95% CI:2.7–7.9), and neonatal intensive care unit (NICU) admission (aOR 4.7; 95% CI:2.4–9.3). GDM demonstrated intermediate risks, preterm birth (aOR=3.3; 95% CI:1.6–6.8) and NICU admission (aOR=2.9; 95% CI:1.5–5.8). Conclusion: Both conditions independently amplify perinatal risks in adolescents, with preeclampsia conferring the most severe outcomes.