Clinical and Previous Obstetric Risk Factors Associated With Gestational Diabetes in Pregnancy

Background: Gestational diabetes mellitus (GDM) is influenced by several maternal and previous obstetric risk factors.Identification of these factors may help in early risk assessment during pregnancy. This study evaluated the association ofclinical and previous obstetric factors with recorded GDM. Materials and Methods: This secondary analysis included 100pregnant women from the parent prospective study. Maternal age, BMI, family history of diabetes mellitus, previous GDM,previous macrosomia, previous abortion and previous preterm delivery were assessed. Recorded GDM was used as theprimary outcome. Univariable and multivariable associations were evaluated using Firth penalized logistic regression. Asensitivity analysis was performed using reconstructed IADPSG positivity as the outcome. Results: Recorded GDM waspresent in 46 participants. Family history of diabetes was associated with recorded GDM on univariable analysis (OR 5.33,95% CI 1.65–22.02; p=0.004). Previous GDM (OR 14.45; p=0.014), previous macrosomia (OR 24.07; p=0.001) andprevious abortion (OR 6.04; p=0.006) were also significant. In multivariable analysis, family history of diabetes (aOR 8.58;p<0.001), previous GDM (aOR 30.49; p=0.001), previous macrosomia (aOR 33.73; p<0.001) and previous abortion (aOR5.91; p=0.022) remained significant. Age and BMI were not independently associated with recorded GDM. Theseassociations were not reproduced when IADPSG positivity was used as the outcome. Conclusion: Previous GDM,macrosomia, abortion and family history of diabetes were associated with recorded GDM. Detailed obstetric and familyhistory may support early risk assessment, but clinical risk factors should not replace standard glucose-based testing.