Biochemical and Pathological Determinants of Gestational Diabetes Mellitus among Pregnant Women and Its Effects on Neonatal Outcomes

Abstract

Background: Gestational diabetes mellitus is a common metabolic disorder of pregnancy that may adversely affect maternal and neonatal outcomes if not diagnosed and managed at an early stage. Biochemical factors and pathological factors such as obesity, hypertension, dyslipidaemia, vitamin D deficiency, previous GDM, and family history of diabetes.

Objective: To determine the biochemical and pathological determinants of gestational diabetes mellitus among pregnant women and to assess its effects on neonatal outcomes.

Methods: The descriptive cross sectional study was done at Muhammad College of Medicine, Peshawar from January 2025 to June 2025. The total number of pregnant women that were included in the study were 75; which were obtained through non-probability consecutive sampling. The data collected includes demographic data, obstetric data, clinical, obstetric, biochemical, pathological, lifestyle, and neonatal outcome data which was taken with a structured proforma. Biochemical parameters measured were fasting blood glucose, random blood glucose, HbA1c, lipid profile, hemoglobin and vitamin D level. Pathological determinants included overweight/obesity, raised blood pressure, previous GDM, previous macrosomic baby, dyslipidaemia, vitamin D deficiency, and anemia. Lifestyle-related factors included physical activity, dietary pattern, antenatal visits, and awareness of GDM. The data were analysed with SPSS software. Frequencies, percentages, means and standard deviations were computed. Where applicable the Chi-square test and independent sample t-test were used, and a p value of less than 0.05 was deemed to be statistically significant.

Results: Out of 75 pregnant women, 24 (32.0%) were diagnosed with gestational diabetes mellitus, while 51 (68.0%) had normal glucose tolerance. Women with GDM had higher fasting blood glucose, random blood glucose, HbA1c, triglycerides, and total cholesterol levels compared with non-GDM women. Vitamin D level and HDL cholesterol were lower among women with GDM. Important associated factors included overweight/obesity, family history of diabetes, previous history of GDM, raised triglycerides, vitamin D deficiency, low physical activity, high carbohydrate diet, frequent sugary food intake, poor awareness, and irregular antenatal visits. Neonates of GDM mothers had higher frequencies of macrosomia, neonatal hypoglycemia, and NICU admission compared with neonates of non-GDM mothers.

Conclusion: Gestational diabetes mellitus was common among pregnant women in this study. Both biochemical abnormalities and community-related factors were associated with GDM. Early screening, regular antenatal visits, dietary counseling, safe physical activity, and community awareness programs may help reduce the risk and complications of gestational diabetes mellitus.