Early diagnosis of gestational diabetes mellitus evidence from Asia countries: A meta-analysis and systematic review

Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy associated with substantial maternal and neonatal morbidity. Asian populations demonstrate increased susceptibility to glucose intolerance and may develop gestational diabetes earlier in pregnancy. However, the prevalence and outcomes of early-diagnosed gestational diabetes mellitus (E-GDM) in Asian populations remain incompletely understood.

A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed, ScienceDirect, and Web of Science were searched from database inception to February 2026 to identify studies evaluating gestational diabetes diagnosed before 24 weeks of gestation in Asian populations.

A total of 2329 records were identified, and 17 studies were included, with 16 eligible studies for meta-analysis. E-GDM prevalence ranged from 0.75% to 22.81%, accounting for 9.43%-78.78% of total GDM cases. Compared with conventional GDM, E-GDM was associated with increased risks of C-section or instrumental delivery (OR = 1.13, 95% CI 1.01-1.26), preterm birth (OR = 1.38, 95% CI 1.07-1.78), and insulin therapy requirement (OR = 1.60, 95% CI 1.09-2.36). Most neonatal outcomes were similar between groups. Women with E-GDM showed greater metabolic vulnerability and possible postpartum metabolic dysfunction.

E-GDM in Asian populations identifies women with greater metabolic vulnerability and increased obstetric risk. E-GDM was associated with higher insulin requirements, increased risks of preterm birth and operative delivery, and possible long-term metabolic dysfunction. Harmonized diagnostic criteria and region-specific screening strategies are needed.