Evidence mapPaperPMID 42458734Full record

ArticleActa obstetricia et gynecologica Scandinavica2026

Early- vs. late-onset gestational diabetes: Differential impact on maternal and neonatal outcomes.

Baolai Li, Wenjun Ji, Rui Zhao, Jinchun Zhang

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Article in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Baolai LiDepartment of Obstetrics, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, China.
Wenjun JiDepartment of Obstetrics, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, China.
Rui ZhaoDepartment of Obstetrics, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, China.
Jinchun ZhangDepartment of Obstetrics, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, China.

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6 · The paper itself

Abstract

introductionThe timing of gestational diabetes mellitus (GDM) diagnosis may influence maternal and neonatal outcomes, yet the differential impact of early-onset versus late-onset GDM remains incompletely characterized, particularly in Chinese populations. To compare maternal and neonatal outcomes between early-onset GDM (diagnosed before 20 weeks' gestation) and late-onset GDM (diagnosed at 24-28 weeks' gestation). MATERIAL AND

methodsThis retrospective cohort study included 1847 singleton pregnancies complicated by GDM at Qingdao Municipal Hospital from January 2020 to December 2023. Participants were classified into early-onset (n = 583) and late-onset (n = 1264) groups. Primary outcomes included composite adverse neonatal outcome, preeclampsia, and cesarean delivery. Multivariate logistic regression was performed to calculate adjusted odds ratios (aOR) after controlling for maternal age, pre-pregnancy BMI, nulliparity, family history of diabetes, and chronic hypertension.

resultsWomen with early-onset GDM demonstrated significantly higher rates of insulin requirement (45.8% vs. 21.1%, p < 0.001). Early-onset GDM was associated with increased risks of preeclampsia (aOR 1.85, 95% CI 1.38-2.47), cesarean delivery (aOR 1.84, 95% CI 1.53-2.28), and preterm birth (aOR 2.69, 95% CI 2.05-3.47). Neonatal complications were substantially elevated in the early-onset group, including macrosomia (aOR 1.86, 95% CI 1.41-2.37), neonatal hypoglycemia (aOR 2.04, 95% CI 1.57-2.67), respiratory distress (aOR 2.60, 95% CI 1.78-3.71), and NICU admission (aOR 2.16, 95% CI 1.69-2.74). The composite adverse neonatal outcome occurred in 61.2% of early-onset versus 37.7% of late-onset cases (aOR 2.57, 95% CI 2.13-3.15).

conclusionsEarly-onset GDM may represent a clinically distinct, higher-risk phenotype with notably elevated maternal and neonatal morbidity compared to late-onset disease. Given the observational design and the potential for residual confounding, these findings should be regarded as hypothesis-generating rather than definitive. They require confirmation in prospective, multicenter studies before risk stratification by diagnostic timing or intensified surveillance can be advocated for routine clinical implementation.

Indexed as

early‐onsetgestational diabetes mellituslate‐onsetneonatal outcomespregnancy outcomesrisk stratification

Identifiers

PMID42458734
PMCPMC13394110

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