The impact of gestational diabetes on pregnancy and newborn health in Southern Morocco: A retrospective cohort study

Abstract

Gestational diabetes mellitus (GDM) is a significant public health challenge due to its potential for severe maternal and neonatal complications. Assessing its specific impact in diverse geographical settings is crucial for tailoring effective regional prevention and management strategies. This study aimed to evaluate the impact of GDM on pregnancy outcomes and neonatal health within the Souss Massa region of southern Morocco. This multicenter, retrospective cohort study analyzed the medical records of 910 mother-newborn dyads (455 GDM cases and 455 non-GDM controls) from two regional hospitals between 2020 and 2023. Controls were selected using a 1:1 temporal sequential matching protocol where the medical record of the first eligible non-GDM woman presenting after a case in the same department was included.Statistical analysis was performed using Jamovi (version 2.3.28). GDM was significantly associated with increased risks of maternal complications, including preeclampsia (OR 3.82, 95% CI: 2.03-7.18, p < 0.001), prolonged labor (OR 4.58, 95% CI: 3.41-6.14, p < 0.001), cesarean delivery (OR 2.20, 95% CI: 1.66-2.92, p < 0.001), and preterm delivery (OR 2.50, 95% CI: 1.78-3.57, p < 0.001). Neonates born to GDM mothers had significantly higher odds of macrosomia (OR 2.04, 95% CI: 1.52-2.74, p < 0.001), prematurity (OR 1.53, 95% CI: 1.09-2.15, p = 0.014), hypoglycemia (OR 2.91, 95% CI: 1.98-4.28, p < 0.001), and hypocalcemia (OR 4.24, 95% CI: 2.41-7.49, p < 0.001) compared to controls. In the Souss Massa region, GDM is linked to a substantial increase in adverse maternal and neonatal outcomes. These findings underscore the critical need for appropriate management and rigorous monitoring of pregnant women with GDM to improve both maternal and neonatal prognoses.