Association of Glycaemic Control with Maternal and Neonatal Outcomes in Gestational Diabetes Mellitus: A Prospective Cohort Study

Open Access

Abstract

Background: Gestational diabetes mellitus (GDM) is associated with adverse maternal and neonatal outcomes, and the degree of glycaemic control may influence the risk of these complications. Objective: To evaluate the association between glycaemic control and maternal and neonatal outcomes among women with GDM. Methods & Materials: This prospective cohort study was conducted in the Department of Obstetrics & Gynaecology, Mymensingh Medical College, Mymensingh, Bangladesh, from January to June 2026. A total of 100 women diagnosed with GDM were enrolled and categorized into well-controlled (n=60) and poorly controlled (n=40) groups according to their glycaemic status. Maternal and neonatal outcomes were recorded and compared between the groups. Associations were assessed using appropriate statistical tests, correlation analysis and multivariable logistic regression. Results: The mean age was 30.4 ± 4.8 years. Pre-pregnancy BMI was significantly higher in the poorly controlled group (27.0 ± 3.7 vs. 25.1 ± 3.2 kg/m², p=0.010). Fasting, 1-hour and 2-hour postprandial glucose and HbA1c were significantly higher among poorly controlled women (all p<0.001). Pre-eclampsia was more frequent in poorly controlled GDM (17.5% vs. 5.0%, p=0.041). Their neonates had higher birth weight (3485 ± 465 vs. 3068 ± 382 g, p<0.001), with increased macrosomia, LGA, neonatal hypoglycaemia and NICU admission. Glycaemic parameters positively correlated with birth weight. Poor glycaemic control independently predicted adverse neonatal outcomes (adjusted OR 3.42, 95% CI: 1.38-8.47; p=0.008). Conclusion: Poor glycaemic control was associated with increased maternal and neonatal complications. Optimal glycaemic management may improve pregnancy outcomes in women with GDM.