Gestational Diabetes Diagnosed Early in Pregnancy: Effects on Pregnancy Outcomes and Gestational Weight Gain

The diagnosis and management of gestational diabetes mellitus (GDM) before 24 weeks of gestation are controversial topics. While some retrospective studies have shown that early diagnosis of GDM significantly impacts pregnancy outcomes, recent randomized controlled trials have found no benefit. This disparity in findings raises essential questions about the optimal timing of GDM diagnosis and its potential impact on maternal and neonatal outcomes.

We aimed to compare pregnancy outcomes between women with GDM diagnosed early and those diagnosed during routine second-trimester screening.

This retrospective cohort study compared outcomes between women with early GDM diagnosed at < 14 weeks and those with GDM diagnosed at 24-28 weeks. Maternal and neonatal outcomes and the need for pharmacotherapy were compared using appropriate statistical tests.

Of 437 women with GDM, 113 (25.9%) were diagnosed early, and 324 (74.1%) were diagnosed in the second trimester. Women diagnosed early had a higher prepregnancy BMI and gained less weight during pregnancy compared to those diagnosed later (p < 0.05). However, maternal and neonatal outcomes and the need for pharmacotherapy did not significantly differ between the groups.

An early diagnosis of GDM before 14 weeks, despite a higher BMI, was associated with less gestational weight gain but did not lead to significant differences in pregnancy outcomes or mode of treatment compared to later diagnosis.