Complications and risk factors of early-onset versus late-onset gestational diabetes mellitus: A cohort study from Saudi Arabia

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Figure 1
- Number of Number of GDM cases diagnosed per gestational week. cases diagnosed per gestational week.

Table 1

- Pregestational maternal risk factors.

Variables	Total (N=172)	Ed-GDM (n=59)	Ld-GDM (n=113)	P-value
Median maternal age (IQR)	35 (8)	34 (8)	35 (8)	0.75
Median parity (IQR)	3 (3)	3 (3)	3 (3)	0.91
Median interpregnancy interval (IQR)	3 (3)	2 (2)	3 (3)	0.10
History of previous GDM, n (%)	101 (58.7)	43 (72.9)	58 (51.3)	0.01^*
History of macrosomia in previous pregnancy, n (%)	14 (8.1)	6 (10.2)	8 (7.6)	0.58
Median pregestational BMI (IQR)	28 (8)	29 (9)	27 (7)	0.05^*
Pre-existing hypertension, n (%)	36 (20.9)	16 (26.2)	20 (18.2)	0.22
Diabetes in first-degree relatives, n (%)	132 (76.7)	48 (81.4)	84 (74.3)	0.30
Presence of hypothyroidism, n (%)	45 (26.2)	16 (27.1)	29 (25.7)	0.84

↵* P-values indicate significant differences, IQR: interquartile range, BMI: body mass index, Ed-GDM: early-diagnosed gestational diabetes mellitus, Ld-GDM: late-diagnosed gestational diabetes mellitus

Table 2

- Prenatal maternal and neonatal risk factors.

Variables	Total (N=172)	Ed-GDM (n=59)	Ld-GDM (n=113)	P-value
Maternal complications
Type of therapy, n (%)				0.01^*
Diet	74 (43.0)	17 (28.8)	57 (50.4)
Metformin	46 (26.7)	17 (28.8)	29 (25.7)
Insulin	43 (25)	19 (32.2)	24 (21.2)
Insulin and metformin	9 (5.2)	6 (10.2)	3 (2.7)
Mode of delivery, n (%)
Vaginal birth	74 (43)	22 (41.5)	52 (52.5)	0.68
Elective caesarean	38 (22.1)	15 (28.8)	23 (23.2)
Emergency caesarean	22 (12.8)	8 (15.4)	14 (14.1)
Instrumental delivery	17 (9.9)	7 (13.5)	10 (10.1)
Maternal birth trauma, n (%)	37 (21.5)	12 (20.3)	25 (22.1)	0.79
Median time of delivery (IQR), weeks	38 (1)	38 (1)	38 (1)	0.18
Gestational hypertension, n (%)	10 (5.8)	6 (10.2)	4 (3.5)	0.08
Development of pre-eclampsia, n (%)	8 (4.7)	6 (10.2)	2 (1.8)	0.02^*
Median fasting glucose (IQR), mg/dl	95 (10)	95 (10)	95 (10)	0.79
Median postprandial glucose (IQR), mg/dl	126.5 (20)	130 (20)	120 (20)	0.08
Neonatal complications
Median fetal birth weight (IQR), kg	3 (0)	3.1 (1)	3 (0)	0.03^*
IUFD, n (%)	3 (1.7)	3 (6.1)	0 (0)	0.02^*
Need for NICU admission, n (%)	8 (4.7)	4 (8.5)	4 (4.3)	0.31

↵* P-values indicate significant differences. IQR: interquartile range, NICU: neonatal intensive care unit, IUFD: intrauterine fetal death, Ed-GDM: early-diagnosed gestational diabetes mellitus, Ld-GDM: late-diagnosed gestational diabetes mellitus

Table 3

- Maternal postpartum complications.

Variables	Total (N=172)	Ed-GDM (n=59)	Ld-GDM (n=113)	P-value
Patient did not follow up postpartum, n (%)	100 (58.1%)	32 (54.2%)	68 (60.2)	0.36
Normal glucose tolerance, n (%)	38 (22.1%)	11 (18.6%)	27 (23.9)
Impaired glucose tolerance, n (%)	26 (15.1%)	12 (20.3%)	14 (12.4)
Progression to diabetes mellitus, n (%)	8 (4.7%)	4 (6.8%)	4 (3.5)
Median postpartum BMI (IQR)	31 (9)	32 (8)	30 (8)	0.04^*
Median maternal weight gain (IQR), kg	9 (6)	8 (5)	9 (5)	0.28

↵* P-values indicate significant differences. IQR: interquartile range, Ed-GDM: early-diagnosed gestational diabetes mellitus, Ld-GDM: late-diagnosed gestational diabetes mellitus, BMI: body mass index

Table 4

- Adjusted odds ratios for the impact of early-onset GDM on maternal and neonatal complications.

Maternal and neonatal complications	aOR	95% CI		P-value
Maternal and neonatal complications	aOR	Lower	Upper	P-value
Pre-eclampsia	6.38	1.17	34.88	0.03^*
Preterm labor	0.28	0.06	1.3	0.10
Gestational hypertension	0.92	0.09	9.5	0.94
Instrumental delivery	1.16	0.37	3.57	0.8
Maternal birth trauma	1.01	0.46	2.5	0.9
Need for insulin to control hyperglycemia	2.09	1.03	4.24	0.04^*
Macrosomia	1.17	0.49	1.17	0.72
Need for NICU admission	1.88	0.26	13.57	0.53