Does the timing and method of gestational diabetes diagnosis influence pregnancy and delivery outcomes

Introduction: Gestational diabetes (GD) is a pregnancy-related condition characterized by carbohydrate metabolism disorders that fall short of diabetes mellitus criteria. It is the most common endocrinopathy during pregnancy, with rising prevalence worldwide. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study linked mild maternal hyperglycemia to increased risks of pregnancy and delivery complications. Methods: The retrospective study analyzed data from 440 women who gave birth in 2020 and were diagnosed with GD. The data were collected from the Birth Registry, Pregnancy Records (Form F113/a), and Birth Histories (Form No. 096/1). Participants were categorized into two groups based on the timing and method of GD diagnosis: the early diagnosis group (diagnosed during the first antenatal visit with fasting venous plasma glucose ≥ 5.1 mmol/L) and the late diagnosis group (diagnosed via oral glucose tolerance test (OGTT) performed at 24+0–28+6 weeks of gestation, with at least one pathological glucose level: fasting glucose 5.1–6.9 mmol/L, 1-hour post-75 g glucose ≥ 10.0 mmol/L, or 2-hour post-75 g glucose 8.5–11.0 mmol/L). Data were analyzed using Microsoft Excel and IBM SPSS Statistics 27.0. Statistical tests (χ2 and t-tests) were employed, with results considered significant at p<0.05. Results: Of 440 women, 263 (59.8%) were in the early diagnosis group and 177 (40.2%) in the late group. Obesity (p=0.031) and BMI > 40 (p=0.043) were more common in the early group. Early diagnosis was also associated with gestational weight gain <11 kg (p=0.025), while late diagnosis correlated with weight gain >16 kg (p=0.006). Fasting glucose was higher in the early group (p=0.001). Late diagnosis was more often managed with lifestyle changes alone (p=0.012), whereas early diagnosis required insulin therapy more frequently (p=0.015). Complications were higher in the late group, including polyhydramnios (p=0.049), preeclampsia (p=0.037), large-for-gestational-age neonates (p=0.028), and macrosomia (p=0.031). Labor induction (p=0.042), earlier inductions (p=0.007), and cesarean sections (p=0.048) were more common in the late group. Conclusions: The timing and method of gestational diabetes (GD) diagnosis affect pregnancy outcomes. Early diagnosis is linked to higher BMI and insulin therapy, while late diagnosis increases risks of complications such as polyhydramnios, preeclampsia, macrosomia, and cesarean delivery. Timely diagnosis and management are crucial for improving outcomes.