Adverse maternal and foetal outcomes in pregnant women with hyperglycaemia in a low-middle-income country

Hyperglycaemia in pregnancy is an increasing public health problem in Sri Lanka, but national data on associated maternal and neonatal outcomes remain limited. The findings are expected to be used for planning care, clinical decision-making, and patient education. To investigate the prevalence of hyperglycaemia in pregnancy (HIP) and its associations with maternal and neonatal outcomes in Sri Lanka. A retrospective cohort study was conducted across four hospitals in Sri Lanka, analysing data from 1350 pregnant women during 2023. Gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) were diagnosed using the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria and WHO 1999 criteria. Maternal outcomes included delivery mode and obstetric complications, and neonatal outcomes included preterm birth, low birth weight, and adverse conditions. Quantitative data were analysed using chi-square test trends and analysis of variance (ANOVA), with a significance level set at 5%. Among the participants, GDM and T2DM were observed in 14.9% and 3.0% of pregnancies, respectively. Hyperglycaemia was significantly associated with higher rates of instrumental delivery, preterm birth, and neonatal hyperbilirubinaemia (17.4% in GDM, 22.5% in T2DM), neonatal sepsis (18.4% in GDM, 37.5% in T2DM), and respiratory support. However, no significant differences were observed in the rates of caesarean delivery or stillbirth. Hyperglycaemia in pregnancy was significantly associated with the risk of adverse maternal and neonatal outcomes, underscoring the importance of early screening, glycaemic control, and multidisciplinary care. Integrating maternal health services with national non-communicable disease programmes is crucial for mitigating these risks.