Gestational diabetes mellitus in patients undergoing assisted reproductive techniques or conceiving spontaneously: an analysis on maternal and foetal outcomes.

Abstract

With the rise of medically assisted reproductive techniques (ART) the number of pregnanciescomplicated by gestational diabetes mellitus (GDM) has increased. The aim of this study was to evaluateretrospectively the outcomes of pregnancies complicated by GDM who conceive trough ART (cases) compared tothose who conceived spontaneously (controls). In 670 women with GDM, 229 cases and 441 controls, followed by the Diabetology of Padua, between2010-2022, clinical-metabolic maternal characteristics and maternal-foetal outcomes were evaluated. As for the maternal clinical-metabolic characteristics, plasma glucose levels at 60' and 120' under oralglucose tolerance test (OGTT) at time of diagnosis were significantly higher in cases (177.4 ± 31.1 vs 170.9 ± 34.1 mg/dl, p = 0.016; 151.5 ± 32.2 vs 144.0 ± 33.4 mg/dl, p = 0.005 respectively). Furthermore, at diagnosis, cases showhigher levels of total cholesterol (257 ± 53 mg/dl vs 246 ± 52 mg/dl; p = 0.012) and triglycerides (199.8 ± 83.2 mg/dl vs 184.9 ± 71.3 mg/dl; p = 0.02) compared to controls. As for maternal outcomes, thyroid disfunction, was recorded in ahigher percentage in case (21.4% vs 14.3%; p = 0.008), as well as, the frequency of cesarean section (50.3% vs41.2%; p = 0.038) and twin pregnancies (16.2% vs 2.5%; p < 0.001). As for neonatal outcomes, there were nostatistically significant differences, except for the birth weight of the second twin, which was significantly lower incases (2268 ± 536 vs 2822 ± 297 g; p = 0.002). No other significant differences were found. This study showed no meaningful differences in the outcomes of GDM pregnancies who were conceived with ART compared to that arose spontaneously as the patients were promptly diagnosed and treated.