Effects of diabetes mellitus during pregnancy on pregnancy outcomes and growth and development of children aged 0-6 years: a retrospective cohort study.

BACKGROUND: Gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PGDM) are jointly termed as diabetes mellitus during pregnancy. This condition exhibits a relatively high incidence rate and exerts adverse impacts on both the mother and the fetus. OBJECTIVE: To investigate the differential pregnancy outcomes and offspring development between pregnant women with and without diabetes mellitus during pregnancy. METHODS: A retrospective cohort study was carried out in China. From 2014 to 2016, all pregnant women in a specific region of Beijing who met the exclusion criteria, along with their offspring who had undergone physical examinations at ages ranging from 0 to 6, were selected as the research subjects between 2014 and 2023. We analyzed the outcomes separately for women with PGDM and GDM. SPSS 27.0 and R 4.2.2 were used to analyze the data. RESULTS: This three-year retrospective study included 49,912 deliveries from a specific region of Beijing, among which 49,765 were live births. The overall prevalence of diabetes during pregnancy was 8.6%, comprising 4,003 cases of GDM and 284 cases of PGDM. PGDM significantly increased the risks of neonatal hypoglycemia (OR 17.344, 95% CI 11.703-25.703) and neonatal infection (OR 8.043, 95% CI 5.584-11.585) (p < 0.001). GDM was identified as an independent risk factor for multiple adverse pregnancy outcomes. Notably, the strongest associations were observed for neonatal hypoglycemia (OR 7.299, 95% CI 5.844-9.116), pathological jaundice (OR 7.264, 95% CI 5.923-8.910), neonatal infection (OR 2.876, 95% CI 2.415-3.424), asphyxia neonatorum (OR 2.435, 95% CI 1.802-3.291), macrosomia (OR 1.355, 95% CI 1.217-1.508), and cesarean section (OR 1.207, 95% CI 1.131-1.288) (all p < 0.001). This study statistically analyzed 18, 590 pairs of mothers and children who had completed the national standard health check-up for children aged 0 to 6. Newborns in the diabetes during pregnancy group exhibited significantly higher body length and weight at birth compared to those in the non-diabetes group (p < 0.001), However, from 3 to 72 months of age, the body length and weight distributions of children in both groups gradually converged, with the differences diminishing over time. CONCLUSIONS: Diabetes mellitus during pregnancy is associated with a substantially increased risk of adverse outcomes for both the mother and the neonate. Nevertheless, the influence on childhood physical development remains indeterminate. Strengthened screening and management of high-risk pregnant women, particularly those with diabetes, are of critical importance for reducing the incidence of adverse pregnancy outcomes and enhancing the health of both mothers and their progeny.