Current trends in the prevalence of gestational diabetes mellitus and fetal macrosomia based on the data obtained at level 3 Perinatal Center
Tysyachny O.V., Baev O.R.
Against the backdrop of the global obesity epidemic and the related metabolic disorders, the prevalence of gestational diabetes mellitus (GDM) has increased with a steadily rising trend over recent years. Glucose is transported across the placenta and transferred to the fetal circulation, that increases the risk of fetal macrosomia. Fetal macrosomia is associated with high incidence of obstetric and neonatal complications. Therefore, it is of interest to explore the frequency of fetal macrosomia in women with GDM.
Objective. To explore the frequency of GDM and large fetuses in primiparous women.
Materials and methods. This cross-sectional study included analysis of 1.165 birth records. A total of 1,004 women and their newborn babies, who met the inclusion criteria, were included in the study and divided into two groups. The comparison group consisted of women without GDM (n=787). The main group consisted of women diagnosed with GDM (n=217).
Results. The women who refused to undergo oral glucose tolerance test (6.43%) were excluded from the study. The incidence of GDM in the examined cohort was 21.19% (diet therapy was used in 80.5% of cases and insulin therapy in 19.6%). In the GDM group, pre-pregnancy weight and BMI were higher, and the prevalence of obesity was more common. However, significantly less weight gain during pregnancy was in the GDM group – 9 kg versus 12 kg (p<0.0001). This was probably due to adherence to the recommended diet and treatment. Newborn’s body weight in the GDM group was on average 104 g less than in the comparison group –3340 g versus 3444 g (p=0.01). Furthermore, body weight of 2500–3499 g was more common (p<0.05) in the GDM group versus 3500–4999 g in the comparison group. There was no difference between the groups in the prevalence of large-for-gestational-age fetuses and fetal macrosomia (у автора: large fetuses) – 15.88% versus 15.20%, and 8.89% versus 6.45%, respectively (p<0.05). At the same time, birth weight of ≥4500 g was registered 5.5 times more often (1.38% versus 0.25%) in patients with GDM (p=0.06).
Conclusion. These findings confirm our assumption about the increasing incidence of carbohydrate metabolism disorders in pregnant women. The obtained results also showed high incidence of fetal macrosomia in the group of women without traditional risk factors, that indicates the need to search new clinical and laboratory predictors of its development. To obtain the data on the prevalence of GDM in the general population of women in Russia, further research is necessary using larger and more diverse sample, encompassing medical facilities in different regions, with the lowest refusal rate.
Authors' contributions. Baev O.R. – the study concept and design, manuscript editing; Tysyachny O.V. – material collection and processing, statistical data analysis and visualization, manuscript writing.
Conflicts of interest. The authors confirm that they have no conflict of interest to declare.
Funding. The study was carried out without any sponsorship.
Ethical Approval. The study was approved by the local Ethics Committee of V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Generative Artificial Intelligence. No generative AI was used in preparing this article.
Patient Consent for Publication. The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Tysyachny O.V., Baev O.R. Current trends in the prevalence of gestational diabetes mellitus
and fetal macrosomia based on the data obtained at level 3 Perinatal Center.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (7): 58-65 (in Russian)
https://dx.doi.org/10.18565/aig.2026.116
Keywords
large for gestational age fetus
fetal macrosomia
large fetus
gestational diabetes mellitus
References
- Hivert M.F., White F., Allard C., James K., Majid S., Aguet F. et al. Placental IGFBP1 levels during early pregnancy and the risk of insulin resistance and gestational diabetes. Nat. Med. 2024; 30(6): 1689-95. https://dx.doi.org/10.1038/s41591-024-02936-5
- Wang H., Li N., Chivese T., Werfalli M., Sun H., Yuen L. et al. IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria. Diabetes Res. Clin. Pract. 2022; 183: 109050. https://dx.doi.org/10.1016/j.diabres.2021.109050
- Sweeting A., Hannah W., Backman H., Catalano P., Feghali M., Herman W.H. et al. Epidemiology and management of gestational diabetes. Lancet. 2024; 404(10448): 175-92. https://dx.doi.org/10.1016/S0140-6736(24)00825-0
- Lao T.T., Ho L.F., Chan B.C.P., Leung W.C. Maternal age and prevalence of gestational diabetes mellitus. Diabetes Care. 2006; 29(4): 948-9. https://dx.doi.org/10.2337/diacare.29.04.06.dc05-2568
- Simmons D., Immanuel J., Hague W.M., Teede H., Nolan C.J., Peek M.J. et al. Treatment of gestational diabetes mellitus diagnosed early in pregnancy. N. Engl. J. Med. 2023; 388(23): 2132-44. https://dx.doi.org/10.1056/NEJMoa2214956
- Lowe L.P., Perak A.M., Kuang A., Lloyd-Jones D.M., Sacks D.A., Deerochanawong C. et al. Associations of glycemia and lipid levels in pregnancy with dyslipidemia 10–14 years later: the HAPO follow-up study. Diabetes Res. Clin. Pract. 2022; 185: 109790. https://dx.doi.org/10.1016/j.diabres.2022.109790
- Ye W., Luo C., Huang J., Li C., Liu Z., Liu F. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2022; 377: e067946. https://dx.doi.org/10.1136/bmj-2021-067946
- O’Tierney-Ginn P., Presley L., Myers S., Catalano P. Placental growth response to maternal insulin in early pregnancy. J. Clin. Endocrinol. Metab. 2015; 100(1): 159-65. https://dx.doi.org/10.1210/jc.2014-3281
- Kamana K.C., Shakya S., Zhang H. Gestational diabetes mellitus and macrosomia: A literature review. Ann. Nutr. Metab. 2015; 66(Suppl. 2): 14-20. https://dx.doi.org/10.1159/000371628
- Beta J., Khan N., Khalil A., Fiolna M., Ramadan G., Akolekar R. Maternal and neonatal complications of fetal macrosomia: systematic review and meta‐analysis. Ultrasound Obstet. Gynecol. 2019; 54(3): 308-18. https://dx.doi.org/10.1002/uog.20279
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Гестационный сахарный диабет. 2014. [Ministry of Health of the Russian Federation. Clinical guidelines. Gestational diabetes mellitus. 2014. (in Russian)].
- Андреева Е.Н., Арбатская Н.Ю., Аржанова О.Н., Башмакова Н.В., Боровик Н.В., Бурумкулова Ф.Ф., Галстян Г.Р., Григорян О.Р., Гринева Е.Н., Дерябина Е.Г., Дедов И.И., Демидова И.Ю., Древаль А.В., Есаян Р.М., Зазерская И.Е., Ибрагимова Л.И., Капустин Р.В., Лукановская О.Б., Мальгина Г.Б., Мельниченко Г.А., Петрухин В.А., Путилова Н.В., Рагозин А.К., Радзинский В.Е., Серов В.Н., Старцева Н.М., Тиселько А.В., Фадеев В.В., Ходжаева З.С., Шестакова М.В., Шмаков Р.Г., Ярыгина Т.А. Клинические рекомендации «Гестационный сахарный диабет» Минздрава России. Версия 2024 года. Вестник репродуктивного здоровья. 2025; 4(1): 12-24. https://dx.doi.org/10.14341/brh12758 [Andreeva E.N., Arbatskaya N.Yu., Arzhanova O.N., Bashmakova N.V., Borovik N.V., Burumkulova F.F., Galstyan G.R., Grigoryan O.R., Grineva E.N., Deryabina E.G., Dedov I.I., Demidova I.Yu., Dreval A.V., Esayan R.M., Zazerskaya I.E., Ibragimova L.I., Kapustin R.V., Lukanovskaya O.B., Malgina G.B., Melnichenko G.A., Petrukhin V.A., Putilova N.V., Ragozin A.K., Radzinskiy V.E., Serov V.N., Startseva N.M., Tiselko A.V., Fadeyev V.V., Khodzhaeva Z.S., Shestakova M.V., Shmakov R.G., Yarygina T.A. Clinical recommendations «gestational diabetes mellitus» of the russian ministry of health. Version of the year 2024. Bulletin of Reproductive Health. 2025; 4(1): 12-24 (in Russian). https://dx.doi.org/10.14341/brh12758].
- Lachmann E.H., Fox R.A., Dennison R.A., Usher‐Smith J.A., Meek C.L., Aiken C.E. Barriers to completing oral glucose tolerance testing in women at risk of gestational diabetes. Diabet Med. 2020; 37(9): 1482-9. https://dx.doi.org/10.1111/dme.14292
- Hocaoğlu M. Why some pregnant women refuse glucose challenge test? Turkish pregnant women’ s perspectives for gestational diabetes mellitus screening. North Clin. Istanbul. 2018; https://dx.doi.org/10.14744/nci.2018.37167.
- Ушанова Ф.О., Лобанова К.Г., Переходов С.Н. Гестационный сахарный диабет: особенности течения и исходы беременности в реальной клинической практике. Медицинский Совет. 2021; (7): 184-91. https://dx.doi.org/10.21518/2079-701X-2021-7-184-191 [Ushanova F.O., Lobanova K.G., Perekhodov S.N. Gestational diabetes mellitus: peculiarities of course and pregnancy outcomes in real clinical practice.. Medical Council. 2021; (7): 184-91 (in Russian). https://dx.doi.org/10.21518/2079-701X-2021-7-184-191].
- Атаев О.Г., Миргородская О.В., Маношкина Е.М. Основные тенденции заболеваемости беременных женщин в субъектах Центрального федерального округа. Социальные аспекты здоровья населения. 2025; 71(3S): 19. https://dx.doi.org/10.21045/2071-5021-2025-71-3S-19 [Ataev O.G., Mirgorodskaya O.V., Manoshkina E.M. The main trends in the incidence of pregnant women in the subjects of the Central Federal District. Social'nye aspekty zdorov'a naselenia. 2025; 71(3S): 19 (in Russian). https://dx.doi.org/10.21045/2071-5021-2025-71-3S-19].
- Maayan‐Metzger A., Schushan‐Eisen I., Strauss T., Globus O., Leibovitch L. Gestational weight gain and body mass indexes have an impact on the outcomes of diabetic mothers and infants. Acta Paediatr. 2015; 104(11): 1150-5. https://dx.doi.org/10.1111/apa.13166
- Wang N., Ding Y., Wu J. Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight in women with gestational diabetes mellitus. Early Hum. Dev. 2018; 124: 17-21. https://dx.doi.org/10.1016/j.earlhumdev.2018.07.008
- Viecceli C., Remonti L.R., Hirakata V.N., Mastella L.S., Gnielka V., Oppermann M.L.R. et al. Weight gain adequacy and pregnancy outcomes in gestational diabetes: a meta‐analysis. Obes. Rev. 2017; 18(5): 567-80. https://dx.doi.org/10.1111/obr.12521
- Faucher M.A., Barger M.K. Gestational weight gain in obese women by class of obesity and select maternal/newborn outcomes: a systematic review. Women and Birth. 2015; 28(3): e70-9. https://dx.doi.org/10.1016/j.wombi.2015.03.006
- Franz M.J. Lifestyle modifications for diabetes management. Endocrinol. Metab. Clin. North Am. 1997; 26(3): 499-510. https://dx.doi.org/10.1016/S0889-8529(05)70263-2
- Kurtzhals L.L., Nørgaard S.K., Secher A.L., Nichum V.L., Ronneby H., Tabor A. et al. The impact of restricted gestational weight gain by dietary intervention on fetal growth in women with gestational diabetes mellitus. Diabetologia. 2018; 61(12): 2528-38. https://dx.doi.org/10.1007/s00125-018-4736-6
- Yamamoto J.M., Kellett J.E., Balsells M., García-Patterson A., Hadar E., Solà I. et al. Gestational diabetes mellitus and diet: a systematic review and meta-analysis of randomized controlled trials examining the impact of modified dietary interventions on maternal glucose control and neonatal birth weight. Diabetes Care. 2018; 41(7): 1346-61. https://dx.doi.org/10.2337/dc18-0102
- Yang G.R., Dye T.D., Li D. Effects of pre-gestational diabetes mellitus and gestational diabetes mellitus on macrosomia and birth defects in Upstate New York. Diabetes Res. Clin. Pract. 2019; 155: 107811. https://dx.doi.org/10.1016/j.diabres.2019.107811
- de Wit L., Bos D.M., van Rossum A.P., van Rijn B.B., Boers K.E. Repeated oral glucose tolerance tests in women at risk for gestational diabetes mellitus. Eur. J. Obstet. Gynecol. Reprod. Biol. 2019; 242: 79-85. https://dx.doi.org/10.1016/j.ejogrb.2019.09.022
- Mohr Sasson A., Shats M., Goichberg Z., Mazaki-Tovi S., Morag I., Hendler I. Oral glucose tolerance test for suspected late onset gestational diabetes. J. Matern. Neonatal. Med. 2021; 34(23): 3928-32. https://dx.doi.org/10.1080/14767058.2019.1702945
- Abu Shqara R., Or S., Wiener Y., Lowenstein L., Frank Wolf M. Clinical implications of the 100-g oral glucose tolerance test in the third trimester. Arch. Gynecol. Obstet. 2022; 307(2): 421-9. https://dx.doi.org/10.1007/s00404-022-06520-5
- Abu Shqara R., Or S., Nakhleh Francis Y., Wiener Y., Lowenstein L., Wolf M.F. Third trimester re‐screening for gestational diabetes in morbidly obese women despite earlier negative test can reveal risks for obstetrical complications. J. Obstet. Gynaecol. Res. 2023; 49(3): 852-62. https://dx.doi.org/10.1111/jog.15515
Received 08.04.2026
Accepted 25.06.2026
About the Authors
Oleg V. Tysyachny, PhD, Researcher at the 1st Maternity Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Oparina str., 4, o_tysyachny@oparina4.ru, https://orcid.org/ 0000-0001-9282-9817Oleg R. Baev, Dr. Med. Sci., Head of the 1st Maternity Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Oparina str., 4; Professor at the Department of Obstetrics, Gynecology, Perinatology, and Reproductology,
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), metod_obsgyn@hotmail.com, https://orcid.org/0000-0001-8572-1971
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