Endocrine Abstracts

JOINT2351

Gestational diabetes mellitus (GDM) refers to glucose intolerance of variable severity that begins or is diagnosed for the first time during pregnancy and resolves immediately after birth. Although this condition often resolves after giving birth, it can increase the risk of developing type 2 diabetes in the future. The primary aim of our study was to evaluate the possible determinants of maternal-neonatal outcomes in women diagnosed with GDM, in our center between 2021 and 2024.A secondary objective was to evaluate whether the type of birth, spontaneous, or induced, could determine a different risk of neonatal complications or a different category of neonatal weight, classified as adequate weight for gestational age (AGA), small for gestational age (SGA) or large for gestational age (LGA). We initially evaluated 150 women attending our outpatient clinic. Only those who had at least one follow-up visit after birth were included, for a total of 59 women included in the study. We used multivariable regression models to identify clinical predictors of materno-fetal outcomes, namely post-pregnancy maternal weight and glycemia, and offspring birthweight and perinatal complications. Maternal baseline weight, weight gain during pregnancy, treatment for GDM, breastfeeding, assisted fertilization were included as possible predictors. The correlations between postpartum fetal complications, offspring birth weight and weight category, and type of delivery were also evaluated.A total of 59 women were included in the analysis (age 34±5,3 years, BMI 25±7,2 kg*m^-2). Higher pre-pregnancy weight (β 0.850 P = 0.000) and greater weight gain during pregnancy (β 0.889 P = 0.016) were the best predictors of post-pregnancy weight. Similarly, regarding neonatal weight, the determinants that emerged were the mother’s pre-pregnancy weight (β 16.88 P = 0.035) and maternal weight gain during pregnancy (β 58.18 P = 0.019); lastly, earlier diagnosis of GDM (β -0.37, P = 0.057) and insulin treatment during pregnancy (β -5.677, P = 0.061), were associated with a tendency to have higher post-partum fasting glycemia When comparing different birthing methods, these appeared to have no influence on fetal perinatal complications or weight. Our study highlights how the mother’s pre-pregnancy weight is a fundamental determinant of weight gain during pregnancy, post-pregnancy weight and fetal weight. This calls for public health interventions aimed at avoiding overweight in childbearing age. Women with an early diagnosis of GDM and the use of insulin during pregnancy might be at a greater risk of postpartum impaired fasting glucose. Routinely inducing labor at 39 weeks of pregnancy is not supported by our data but this needs to be confirmed in larger samples.