Continuity of Care and Delivery Outcomes in Pregnant Women with Gestational Diabetes Mellitus: A Retrospective Controlled Study at a Tertiary Hospital in China

Objective: To evaluate the impact of continuity of care on delivery outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: This retrospective controlled study was conducted at a tertiary general hospital in Hubei Province, China. The control group consisted of 60 GDM patients who received standard prenatal care between September 2020 and September 2021. The intervention group included 200 GDM patients who received continuity of care between October 2021 and June 2023. The continuity of care model encompassed health education, dietary and exercise counseling, psychological support, and online follow-up from the time of diagnosis until one week postpartum. Delivery outcomes—including rates of vaginal delivery, pelvic adhesions, premature rupture of membranes, postpartum hemorrhage, dystocia, and manual placental removal—were compared between groups. Results: The intervention group had a significantly higher rate of vaginal delivery compared to the control group (44.5% vs. 28.3%, P = 0.02). Rates of pelvic adhesions (5.5% vs. 28.3%), premature rupture of membranes (2.0% vs. 11.7%), postpartum hemorrhage (1.5% vs. 8.3%), and dystocia (3.5% vs. 18.3%) were significantly lower in the intervention group (P < 0.05). There was no statistically significant difference in the rate of manual placental removal (5.5% vs. 13.3%, P = 0.07). Conclusion: Continuity of care is associated with improved delivery outcomes in pregnant women with GDM and demonstrates strong potential for clinical application in perinatal management.