ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1573470
Gestational Diabetes Mellitus Remains the Risk Factor for Neonatal Adverse Outcomes in Multiparous Women
Provisionally accepted
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Purpose: Following China's universal two-child policy, the number of multiparous women increased by 90 million, coinciding with a rise in gestational diabetes mellitus (GDM). Previous studies have indicated that GDM can be effectively managed through antenatal care and lifestyle interventions. This study aims to explore whether GDM still remains a risk factor for adverse neonatal outcomes among multiparous women after the implementation of the universal two-child policy and the enhancement of antenatal care in China.Method: A total of 7,496 multiparous women were categorized into four groups: those without any complications, those with GDM only, those with non -GDM complications, and those with both GDM and non -GDM complications.Logistic regression models were employed to calculate the adjusted odds ratio (aOR) and its 95% confidence interval (CI) for each outcome. Stratified analysis (based on maternal age) and sensitivity analysis (restricted to multiparas with GDM and/or hypertensive disorders in pregnancy) were carried out to evaluate the robustness of the results.Results: Compared to infants born to multiparous women with GDM alone, infants born to multiparas without any complications had lower risks of preterm birth (PTB) (aOR 0.57, 95% CI 0.46-0.70), macrosomia (aOR 0.60, 95% CI 0.43-0.83), large for gestational age (aOR 0.53, 95% CI 0.44-0.61). When considering multiparous women with GDM with non-GDM complications, the offspring had higher risks of PTB (aOR 1.98, 95% CI 1.33-2.96), LBW (aOR 2.49, 95% CI 1.54-4.01), and small for gestational age (aOR 4.82, 95% CI 2.41-9.65).Despite advancements in China's prenatal care system following the two-child policy , GDM persists as a modifiable, high-impact risk factor for neonatal adverse outcomes in multiparous women. Crucially, the synergistic effects of GDM with other pregnancy complications amplify these risks, necessitating early screening (e.g., first-trimester glucose profiling), intensified glycemic management protocols, and family-centered interventions tailored to China's unique sociodemographic landscape.
Keywords: gestational diabetes mellitus, The universal two-child policy, Multiparous women, Adverse neonatal outcomes, Long-Term Implications
Received: 12 Feb 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Xiang, Zhang, Li, Bin, Luo and Lei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoping Lei, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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