Effects of Gestational Diabetes Mellitus on Maternal and Neonatal Outcomes: A Prospective Cohort Study in Northern Sri Lanka

Abstract

Introduction: Gestational diabetes mellitus (GDM) has emerged as a significant global public health concern due to its association with adverse maternal and neonatal outcomes. The aim of the study was to assess the effects of GDM on maternal and neonatal outcomes. Methods: A prospective cohort study was conducted among 216 pregnant women diagnosed with GDM who were receiving care at Teaching Hospital Jaffna. Women with pre-existing diabetes were excluded from the study. Participants were followed from the time of GDM diagnosis until six weeks postpartum. Data were collected using structured questionnaires and a review of clinical records. Descriptive statistics were used to summarize the demographic and clinical characteristics. The chi-square test was used to assess the association between blood glucose control and adverse maternal and neonatal outcomes. A p-value ≤0.05 was considered statistically significant. Results: The majority of participants (61.1%; n = 132) were aged 35 years or older. More than two-thirds of the participants (67.6%; n=146) were obese. The majority were multiparous (62%; n = 134), and GDM was diagnosed during the second trimester of pregnancy (61.1%; n = 132). A total of 17 mothers (7.9%) experienced a miscarriage during the current pregnancy. Maternal and neonatal complications were reported in 60 (27.8%) and 29 (14.6%) cases, respectively. A significant association was found between blood glucose control and both maternal (p<0.001) and neonatal complications (p=0.007). Conclusion: Despite the provision of multidisciplinary antenatal care for diabetes, women with GDM remain at increased risk for maternal and neonatal complications. Greater emphasis is required on targeting modifiable risk factors, particularly by enhancing adherence to diabetes management strategies during pregnancy.