Pregnancy Outcomes in Indian Women with Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis
Abstract
Background: Gestational diabetes mellitus (GDM) is a significant pregnancy complication linked to adverse maternal and fetal outcomes. The rising prevalence of GDM is emerging as a public health challenge. We aimed to explore the association between GDM and adverse pregnancy outcomes in India.
Methods: A systematic search was performed to identify eligible studies on gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in India based on inclusion & exclusion criteria. The data was analyzed using R Studio. This systematic review and meta-analysis followed PRISMA guidelines and was registered with PROSPERO.
Results: Women with GDM had higher odds of exposure to adverse maternal outcomes such as cesarean section, postpartum hemorrhage, gestational hypertension, and large-for-gestational-age births. Similarly, GDM significantly increased the odds of adverse fetal and neonatal outcomes, including preterm birth, macrosomia, stillbirth, hypoglycemia, hyperbilirubinemia, congenital malformations, and shoulder dystocia. These findings highlight the increased risk burden posed by GDM on both maternal and fetal health outcomes.
Conclusion: GDM poses a substantial risk to both maternal and fetal health, contributing to multiple complications. Early detection and effective management strategies are crucial to mitigating adverse pregnancy outcomes in affected women.
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12. Bener A, Saleh NM, Al-Hamaq A, et al (2011). Prevalence of gestational diabe-tes and associated maternal and neona-tal complications in a fast-developing community: Global comparisons. Int J Womens Health, 3: 367–373.
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14. Prakash GT, Das AK, Habeebullah S, et al (2017). Maternal and neonatal outcome in mothers with gestational diabetes mellitus. Indian J Endocrinol Metab, 21(6): 854-858.
15. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: An updated guideline for reporting system-atic reviews. BMJ, 372: n71.
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17. Rawat D, Chowdhury SR, Yadav AK, et al (2023). Meta-analysis comparing DIPSI versus IADPSG criteria for diagnosis of gestational diabetes among Indian pop-ulation. Taiwan J Obstet Gynecol, 62(4): 498–505.
18. Wahi P, Dogra V, Jandial K, et al (2011). Prevalence of gestational diabetes melli-tus and its outcomes in Jammu region. J Assoc Physicians India, 59: 227–230.
19. Ye W, Luo C, Huang J, et al (2022). Gesta-tional diabetes mellitus and adverse pregnancy outcomes: Systematic review and meta-analysis. BMJ, 377: e067946.
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24. Yang Y, Wu N (2022). Gestational diabetes mellitus and preeclampsia: Correlation and influencing factors. Front Cardiovasc Med, 9: 831297.
25. Lucas IM, Barr ELM, Barzi F, et al (2021). Gestational diabetes is associated with postpartum hemorrhage in Indigenous Australian women: The PANDORA study. Int J Gynecol Obstet, 155(2): 296–304.
26. Kouhkan A, Najafi L, Malek M, et al (2021). Gestational diabetes mellitus: Major risk factors and pregnancy-related out-comes. Int J Reprod Biomed, 19(9): 827–836.
27. Tashfeen K, Hamdi IM (2013). Polyhy-dramnios as a predictor of adverse pregnancy outcomes. Sultan Qaboos Univ Med J, 13(1): 57–62.
28. Sacks DA, Hadden DR, Maresh M, et al (2012). Frequency of gestational diabetes mellitus at collaborating centers based on IADPSG criteria: The HAPO study. Diabetes Care, 35(3): 526–528.
29. Boriboonhirunsarn D, Waiyanikorn R (2016). Emergency cesarean section rate between women with gestational diabe-tes and normal pregnant women. Taiwan J Obstet Gynecol, 55(1): 64–67.
30. Behboudi-Gandevani S, Bidhendi-Yarandi R, Panahi MH, et al (2021). The effect of mild gestational diabetes mellitus treat-ment on adverse pregnancy outcomes: A systematic review and meta-analysis. Front Endocrinol (Lausanne), 12: 640004.
31. Farrar D, Simmonds M, Bryant M, et al (2017). Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes. PLoS One, 12(4): e0175288.
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33. Simmons D, Thompson CF, Conroy C (2015). Incidence and risk factors for neonatal hypoglycaemia among women with gestational diabetes mellitus. Diabet Med, 17(12): 830–834.
34. KC K, Shakya S, Zhang H (2015). Gesta-tional diabetes mellitus and macro-somia: A literature review. Ann Nutr Metab, 66 Suppl 2 : 14–20.
35. He J, Song J, Zou Z, et al (2022). Associa-tion between neonatal hyperbiliru-binemia and hypoglycemia in women with diabetes in pregnancy. Sci Rep, 12(1): 16975.
36. Preda A, Iliescu DG, Comănescu A, et al (2023). Gestational diabetes and preterm birth: What do we know? J Clin Med, 12(14): 4572.
37. Trivedi D, Chavda V, Patel K (2017). A study of gestational diabetes mellitus, its prevalence, risk factors and complica-tions in a tertiary care hospital. J Indian Acad Clin Med, 18(3): 175–179.
38. McElwee ER, Oliver EA, McFarling K, et al (2023). Risk of stillbirth in pregnancies complicated by diabetes, stratified by fetal growth. Obstet Gynecol, 141(4): 801-809.
39. Mi Y, Chen Z, Tang J, et al (2025). Associa-tion between gestational diabetes melli-tus and offspring health: A two-sample Mendelian randomization study. BMC Pregnancy Childbirth, 25: 321.
40. Wu Y, Liu B, Sun Y, et al (2020). Association of maternal prepregnancy diabetes and gestational diabetes mellitus with con-genital anomalies of the newborn. Dia-betes Care, 43(12): 2983–2990.
41. Weir TL, Majumder M, Glastras SJ (2024). A systematic review of the effects of ma-ternal obesity on neonatal outcomes in women with gestational diabetes. Obes Rev, 25(7): e13747.
2. Swaminathan G, Swaminathan A, Corsi DJ (2020). Prevalence of gestational diabe-tes in India by individual socioeconom-ic, demographic, and clinical factors. JAMA Netw Open, 3(11): e2025074.
3. Nga TK, Thanh CN, Linh PV, et al (2024). Prevalence and associated factors of gestational diabetes mellitus: A multi-center, cross-sectional study in Mekong Delta region. TCNCYH, 177(4E14): 83–90.
4. Abera DA, Larbie C, Abugri J, et al (2024). Prevalence and predictors of gestational diabetes mellitus in Sub-Saharan Africa: A 10-year systematic review. Endocrinol Diabetes Metab, 7(3): e00478.
5. Damiri B, Abumohsen H, BelKebir S, et al (2024). The epidemiology of gestational diabetes, gestation hypertension, and anemia in North Palestine from 2018 to 2020: A retrospective study. PLoS One, 19(3): e0301145.
6. Basu S, Maheshwari V, Gokalani R, Lahari-ya C (2024). Prevalence and predictors of gestational diabetes mellitus and overt diabetes in pregnancy: A second-ary analysis of nationwide data from India. Prev Med Res Rev, 1(1): 52-58.
7. Magliano DJ, Boyko EJ, Committee IDA 10th edition scientific (2021). Global picture. In: IDF Diabetes Atlas. 10th ed. Int Diabetes Fed.
8. Bahl S, Dhabhai N, Taneja S, et al (2022). Burden, risk factors and outcomes asso-ciated with gestational diabetes in a population-based cohort of pregnant women from North India. BMC Pregnan-cy Childbirth, 22(1): 32.
9. Sreelakshmi PR, Nair S, Soman B, et al (2015). Maternal and neonatal outcomes of gestational diabetes: A retrospective cohort study from Southern India. J Family Med Prim Care, 4(3): 395–398.
10. Varghese R, Thomas B, Hail MA, et al (2012). The prevalence, risk factors, ma-ternal and fetal outcomes in gestational diabetes mellitus. Int J Drug Dev Res, 4(3): 356–368.
11. Jain R, Pathak RR, Kotecha AA (2014). Ges-tational diabetes: Perinatal and maternal complication in 24–28 weeks. Int J Med Sci Public Health, 3: 1283–1288.
12. Bener A, Saleh NM, Al-Hamaq A, et al (2011). Prevalence of gestational diabe-tes and associated maternal and neona-tal complications in a fast-developing community: Global comparisons. Int J Womens Health, 3: 367–373.
13. Biju PB, Chaudhary RK, Radhakrishnan K, et al (2024). Gestational diabetes and analysis of maternal and fetal outcomes among pregnant women: A cross-sectional study. J Obstet Gynaecol India, 74(5):447-453.
14. Prakash GT, Das AK, Habeebullah S, et al (2017). Maternal and neonatal outcome in mothers with gestational diabetes mellitus. Indian J Endocrinol Metab, 21(6): 854-858.
15. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: An updated guideline for reporting system-atic reviews. BMJ, 372: n71.
16. Luchini C, Stubbs B, Solmi M, et al (2017). Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale. World J Me-ta-Anal, 5(4): 80–84.
17. Rawat D, Chowdhury SR, Yadav AK, et al (2023). Meta-analysis comparing DIPSI versus IADPSG criteria for diagnosis of gestational diabetes among Indian pop-ulation. Taiwan J Obstet Gynecol, 62(4): 498–505.
18. Wahi P, Dogra V, Jandial K, et al (2011). Prevalence of gestational diabetes melli-tus and its outcomes in Jammu region. J Assoc Physicians India, 59: 227–230.
19. Ye W, Luo C, Huang J, et al (2022). Gesta-tional diabetes mellitus and adverse pregnancy outcomes: Systematic review and meta-analysis. BMJ, 377: e067946.
20. Qadir SY, Yasmin T, Fatima I (2012). Ma-ternal and foetal outcome in gestational diabetes. J Ayub Med Coll Abbottabad, 24(3–4): 17–20.
21. Lin X, Zhou L, Si S, et al (2024). Association of the comorbidity of gestational diabe-tes mellitus and hypertensive disorders of pregnancy with birth outcomes. Front Endocrinol (Lausanne), 15: 1468820.
22. Wells G, Bleicher K, Han X, et al (2015). Maternal diabetes, large-for-gestational-age births, and first trimester pregnan-cy–associated plasma protein-A. J Clin Endocrinol Metab, 100(6): 2372–2379.
23. Mishra S, Kotur P, Kaveriappan G, et al (2024). Association of HbA1c value in early pregnancy in nondiabetic preg-nant women with obstetric outcome. J S Asian Fed Obstet Gynaecol, 16(2): 103–106.
24. Yang Y, Wu N (2022). Gestational diabetes mellitus and preeclampsia: Correlation and influencing factors. Front Cardiovasc Med, 9: 831297.
25. Lucas IM, Barr ELM, Barzi F, et al (2021). Gestational diabetes is associated with postpartum hemorrhage in Indigenous Australian women: The PANDORA study. Int J Gynecol Obstet, 155(2): 296–304.
26. Kouhkan A, Najafi L, Malek M, et al (2021). Gestational diabetes mellitus: Major risk factors and pregnancy-related out-comes. Int J Reprod Biomed, 19(9): 827–836.
27. Tashfeen K, Hamdi IM (2013). Polyhy-dramnios as a predictor of adverse pregnancy outcomes. Sultan Qaboos Univ Med J, 13(1): 57–62.
28. Sacks DA, Hadden DR, Maresh M, et al (2012). Frequency of gestational diabetes mellitus at collaborating centers based on IADPSG criteria: The HAPO study. Diabetes Care, 35(3): 526–528.
29. Boriboonhirunsarn D, Waiyanikorn R (2016). Emergency cesarean section rate between women with gestational diabe-tes and normal pregnant women. Taiwan J Obstet Gynecol, 55(1): 64–67.
30. Behboudi-Gandevani S, Bidhendi-Yarandi R, Panahi MH, et al (2021). The effect of mild gestational diabetes mellitus treat-ment on adverse pregnancy outcomes: A systematic review and meta-analysis. Front Endocrinol (Lausanne), 12: 640004.
31. Farrar D, Simmonds M, Bryant M, et al (2017). Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes. PLoS One, 12(4): e0175288.
32. Zhao E, Zhang Y, Zeng X, et al (2015). As-sociation between maternal diabetes mellitus and the risk of congenital mal-formations: A meta-analysis of cohort studies. Drug Discov Ther, 9(4): 274–281.
33. Simmons D, Thompson CF, Conroy C (2015). Incidence and risk factors for neonatal hypoglycaemia among women with gestational diabetes mellitus. Diabet Med, 17(12): 830–834.
34. KC K, Shakya S, Zhang H (2015). Gesta-tional diabetes mellitus and macro-somia: A literature review. Ann Nutr Metab, 66 Suppl 2 : 14–20.
35. He J, Song J, Zou Z, et al (2022). Associa-tion between neonatal hyperbiliru-binemia and hypoglycemia in women with diabetes in pregnancy. Sci Rep, 12(1): 16975.
36. Preda A, Iliescu DG, Comănescu A, et al (2023). Gestational diabetes and preterm birth: What do we know? J Clin Med, 12(14): 4572.
37. Trivedi D, Chavda V, Patel K (2017). A study of gestational diabetes mellitus, its prevalence, risk factors and complica-tions in a tertiary care hospital. J Indian Acad Clin Med, 18(3): 175–179.
38. McElwee ER, Oliver EA, McFarling K, et al (2023). Risk of stillbirth in pregnancies complicated by diabetes, stratified by fetal growth. Obstet Gynecol, 141(4): 801-809.
39. Mi Y, Chen Z, Tang J, et al (2025). Associa-tion between gestational diabetes melli-tus and offspring health: A two-sample Mendelian randomization study. BMC Pregnancy Childbirth, 25: 321.
40. Wu Y, Liu B, Sun Y, et al (2020). Association of maternal prepregnancy diabetes and gestational diabetes mellitus with con-genital anomalies of the newborn. Dia-betes Care, 43(12): 2983–2990.
41. Weir TL, Majumder M, Glastras SJ (2024). A systematic review of the effects of ma-ternal obesity on neonatal outcomes in women with gestational diabetes. Obes Rev, 25(7): e13747.
| Files | ||
| Issue | Vol 55 No 1 (2026) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v55i1.20974 | |
| Keywords | ||
| Gestational diabetes mellitus Maternal health Pregnancy outcomes Fetal outcome Meta-analysis India | ||
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How to Cite
1.
Singh A, Singh J, Mudgal S, Huda R. Pregnancy Outcomes in Indian Women with Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Iran J Public Health. 2026;55(1):76-86.
