ADIPS Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

A Retrospective Analysis of Pregnancy Outcomes in Women with Gestational Diabetes Mellitus: Comparing Medically Assisted Reproductive Therapy and Spontaneous Conception (#118)

Varun Manoharan 1 2 3 , Megha Bhadbhade 3 4 , Vincent Wong 3 4
  1. Department of Endocrinology, Nepean Hospital, Penrith, NSW, Australia
  2. Nepean Clinical School , Faculty of Medicine and Health, The University of Sydney, NSW
  3. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW
  4. Diabetes and Endocrine Service, Liverpool Hospital, NSW

Aim: With the growing use of medically assisted reproductive therapy (ART), this study compares outcomes in pregnant women with gestational diabetes mellitus (GDM) who conceived via ART to those who conceived spontaneously.

Method: In this retrospective study, demographic and clinical outcomes were compared between women with gestational diabetes mellitus (GDM) who delivered a singleton infant at Liverpool Hospital between April 2020 and April 2025, following either spontaneous conception (controls) or conception via ART.

Results and Discussion: In our study, 3,022 women conceived spontaneously, while 98 conceived via ART, with 86 (87.8%) of these cases involving in vitro fertilisation. The ART group was older (34.0 vs 32.0 years, p<0.001), had higher rates of obesity (55.1% vs 45.7%, p=0.02) and polycystic ovarian syndrome (18.4% vs 5.2%, p<0.001), and were more likely to require insulin therapy for GDM management (65.3% vs 47.0%, p<0.001) (Tables 1 and 2). In keeping with the literature, elective Caesarean section1,2 (37.1% vs 25.4%, p=0.04), congenital abnormalities3 (12.6% vs 3.4%, p<0.001), and gestational hypertension4 (15.3% vs 6.9%, p=0.001) were more common in the ART group (Table 3). No significant differences were observed in gravidity, ethnicity, 75g oral glucose tolerance test results, pre-eclampsia rates and other neonatal outcomes (Tables 1, 2 and 3).

Conclusion: Women with GDM who conceived via ART represent a high-risk group, particularly for congenital abnormalities and gestational hypertension. Tailored preconception counselling, close surveillance of glycaemic and blood pressure profiles, and coordinated multidisciplinary care are important to optimise maternal and fetal outcomes in this cohort.68679b4b82f1f-Table+1.jpg68679b4b82f1f-Table+2.jpg68679b4b82f1f-Table+3.jpg

  1. Antoniou E, Orovou E, Iliadou M, Sarella A, Palaska E, Rigas N, Iatrakis G, Dagla M. The Kind of Conception Affects the Kind of Cesarean Delivery in Primiparous Women. Mater Sociomed. 2021 Sep;33(3):188-194.
  2. Lodge-Tulloch NA, Elias FTS, Pudwell J, et al. Caesarean section in pregnancies conceived by assisted reproductive technology: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2021;21:244.
  3. Veeramani M, Balachandren N, Hong YH, Lee J, Corno AF, Mavrelos D, Kastora SL. Assisted reproduction and congenital malformations: A systematic review and meta-analysis. Congenit Anom (Kyoto). 2024 May;64(3):107-115.
  4. Chih HJ, Elias FTS, Gaudet L, et al. Assisted reproductive technology and hypertensive disorders of pregnancy: systematic review and meta-analyses. BMC Pregnancy Childbirth. 2021;21:449.