Gestational and postpartum maternal consequences of gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a significant complication during pregnancy with varying prevalence across countries and ethnicities. In Taiwan, although GDM prevalence rose from 7.6% to 13.4% between 2004 and 2015, its maternal gestational and extended consequences remained underexamined. The nationwide population-based study aims to investigate GDM-related risk factors and identify the critical period during which GDM likely poses long-term health risks.

A total of 206,831 adult pregnant women from the National Health Insurance Research Database were divided into GDM (n = 8,204) and non-GDM (n = 198,627). After 1:1 matching of age and comorbidities, logistic and Cox regression was used to assess the odd and hazard ratio of maternal gestational and extended consequences of GDM. Kaplan-Meier analyses provided follow up events-free outcomes.

The incidence of preterm labor, preeclampsia, and gestational hypertension were significantly higher in the GDM group. The odd ratios of these consequences were 1.72, 2.86, and 2.85, respectively. GDM significantly affected the development of type 2 DM, chronic kidney disease (CKD), and ophthalmic disease. The hazard ratios of these diseases were 2.88, 1.54, and 1.63, respectively. Kaplan-Meier analysis revealed that GDM significantly increased these diseases during follow-up, especially within 2 years for type 2 DM and within 1 year for CKD and ophthalmic disease after delivery.

GDM was associated with higher risks of preterm labor, gestational hypertension, preeclampsia, type 2 DM, CKD, and ophthalmic disease. Postpartum GDM follow-up time is 2 years for type-2 DM and 1 year for CKD and ophthalmic disease.