Endocrinology and Metabolism

Original Article

Diabetes, obesity and metabolism
Metabolic Phenotypes of Women with Gestational Diabetes Mellitus Affect the Risk of Adverse Pregnancy Outcomes: Joon Ho Moon, Sookyung Won, Hojeong Won, Heejun Son, Tae Jung Oh, Soo Heon Kwak, Sung Hee Choi, Hak Chul Jang; Endocrinol Metab. 2025;40(2):247-257. Published online November 28, 2024; DOI: https://doi.org/10.3803/EnM.2024.2089

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Background
Gestational diabetes mellitus (GDM) affects women with diverse pathological phenotypes, but little is known about the effects of this variation on perinatal outcomes. We explored the metabolic phenotypes of GDM and their impact on adverse pregnancy outcomes.
Methods
Women diagnosed with gestational glucose intolerance or GDM were categorized into subgroups according to their prepregnancy body mass index (BMI) and the median values of the gestational Matsuda and Stumvoll indices. Logistic regression analysis was employed to assess the odds of adverse pregnancy outcomes, such as large-for-gestational age (LGA), small-for-gestational age, preterm birth, low Apgar score, and cesarean section.
Results
A total of 309 women were included, with a median age of 31 years and a median BMI of 22.3 kg/m². Women with a higher pre-pregnancy BMI had a higher risk of LGA newborns (adjusted odds ratio [aOR] for pre-pregnancy BMI ≥25 kg/m² compared to 20–23 kg/m², 4.26; 95% confidence interval [CI], 1.99 to 9.12; P<0.001; P for trend=0.001), but the risk of other adverse pregnancy outcomes did not differ according to pre-pregnancy BMI. Women with insulin resistance had a higher risk of LGA (aOR, 1.88; 95% CI, 1.02 to 3.47; P=0.043) and cesarean section (aOR, 2.12; 95% CI, 1.29 to 3.50; P=0.003) than women in the insulin-sensitive group. In contrast, defective β-cell function did not affect adverse pregnancy outcomes.
Conclusion
Different metabolic phenotypes of GDM were associated with heterogeneous pregnancy outcomes. Women with obesity and those with insulin resistance are at greater risk of adverse outcomes and might need strict glycemic management during pregnancy.

Citations

Citations to this article as recorded by

Long-term risk of offspring type 1 and type 2 diabetes following maternal gestational diabetes mellitus: a nationwide birth cohort study with 10-year follow-up
Joon Ho Moon, Han Na Jung, Bongseong Kim, Jaehyun Kim, Young Mi Jung, Hyeon Ji Kim, Jee Yoon Park, Tae Jung Oh, Soo Heon Kwak, Kyung-Do Han, Sung Hee Choi
BMC Medicine.2026;[Epub] CrossRef
Novel inflammatory markers for predicting adverse pregnancy outcomes in pregnant women with polycystic ovary syndrome: a retrospective case‒control study
Na Pan, Jing Zhang, Ning Zhu, Mengting Liu, Shuying Yang, Zhanshuai Song, Haibo Song
BMC Pregnancy and Childbirth.2026;[Epub] CrossRef
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Kyung-Soo Kim, Soo-Kyung Kim, Yong-Wook Cho
Endocrinology and Metabolism.2026; 41(1): 26. CrossRef
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Annals of Medicine.2026;[Epub] CrossRef
Machine learning‐based prediction model for adverse pregnancy outcomes in women with gestational diabetes mellitus
Jooyeop Lee, Seoung‐Ho Choi, Hyeon Ji Kim, Jee Yoon Park, Tae Jung Oh, Sung Hee Choi, Hak Chul Jang, Joon Ho Moon
Journal of Diabetes Investigation.2026;[Epub] CrossRef
Gestational Diabetes Mellitus: Mechanisms Underlying Maternal and Fetal Complications
Jooyeop Lee, Na Keum Lee, Joon Ho Moon
Endocrinology and Metabolism.2025; 40(1): 10. CrossRef
The Characteristics of Course of Pregnancy and Perinatal Outcomes in Women with Gestation Diabetes Mellitus (The Results of Ten-Years Research)
N. V. Batrak, I. V. Ivanova
Problems of Social Hygiene, Public Health and History of Medicine.2025; 33(6): 1414. CrossRef

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