Follow-up and risk factors of pregnant women with gestational diabetes in Morocco.

Abstract

Background: Gestational diabetes mellitus (GDM) represents a significant global public health challenge, posing substantial risks to both maternal and foetal health.

Aim: This study analysed risk factors, follow-up, management approaches and obstetric complications in pregnant women with GDM.

Setting: This study was conducted in Southern Morocco.

Methods: This multicentre retrospective cross-sectional study analysed 297 patient files (n = 120 with GDM) from four maternity hospitals (2019-2023). Data were collected via a standardised form. Statistical analysis included descriptive summaries, group comparisons (Chi-square, Fisher's t-test, Mann-Whitney U) and logistic regression to calculate odds ratios (ORs) using SPSS version 27.

Results: Gestational diabetes mellitus screening was inconsistent: only 17% (95% confidence interval [CI]: 11.5% - 25.6%) of women were screened before 24 weeks of amenorrhea, and 38% (95% CI: 29.8% - 47.5%) between 24 weeks and 28 weeks. The oral glucose tolerance test 75 g was not used. Gestational diabetes mellitus was significantly associated with caesarean delivery (OR = 2.52; 95% CI: 1.29-4.92; p = 0.007 and preeclampsia 5.95 (95% CI: 1.21-29.21; p = 0.028). Risk factors for GDM included maternal age over 35 years and obesity (body mass index [BMI]: ≥ 30). A history of prematurity showed a significant association with GDM, with adjuster OR (aOR) of 3.47 (95% CI: 1.36-8.79; p < 0.011).

Conclusion: Preventing maternal complications from GDM relies on raising women's awareness about the importance of screening and monitoring during pregnancy in Southern Morocco.

Contribution: This study highlights the necessity of strengthening GDM screening and targeted management strategies for at-risk pregnant women in Morocco, particularly in the southern region.