Association of gestational diabetes mellitus with adverse pregnancy outcomes: our experience and meta-analysis

The incidence of gestational diabetes mellitus (GDM) has increased recently worldwide with a subsequent occurrence of the associated adverse pregnancy outcomes. The objective of this study was to estimate the association between women with GDM and adverse pregnancy outcomes based on a cohort study and an integrated meta-analysis. A retrospective cohort of 15,097 pregnant women (1718 GDM with 13,379 non-GDM controls) who delivered at two affiliated medical centers of Nantong University from Jan. 1, 2014 to Sep. 30, 2015, was conducted. Then, a meta-analysis was performed to explore and compare adverse pregnancy outcomes between GDM and non-GDM women. In our cohort study, women with GDM were at significantly greater risk for cesarean section [crude relative risk (RR): 2.20, 95% confidence interval (CI): 1.97–2.44], macrosomia (crude RR: 2.36, 95% CI: 2.04–2.74) and large for gestational age (LGA) (crude RR: 2.03, 95% CI: 1.81–2.27), and a lower risk of low birth weight (LBW) (crude RR: 0.64, 95% CI: 0.47–0.86) and small for gestational age (SGA) (crude RR: 0.60, 95% CI: 0.45–0.80) than GDM-free women. However, the preterm birth incidence was not associated with GDM [crude RR: 1.08, 95% CI: 0.91–1.29]. Similarly, the meta-analysis including our cohort study also showed a significant association between GDM and preterm birth (pooled RR: 1.36, 95% CI: 1.26–1.48). Women with GDM still have an increased incidence of adverse pregnancy outcomes, which indicated that early prevention and clinical treatment of disease should be enhanced.