Gestational diabetes mellitus diagnosed during early pregnancy

Objective: This study was undertaken to compare pregnancy complications, obstetric outcomes, and perinatal outcomes between women with early-onset and late-onset gestational diabetes mellitus. Study Design: Fifty-gram oral glucose challenge screening was conducted among 3986 pregnant women at the time of their first antenatal visit. Women without abnormal results underwent another test at 24 to 28 weeks’ gestation. Patients with gestational diabetes mellitus in early pregnancy were compared with those who had a normal glucose tolerance at the time of this first test but in whom diabetes subsequently developed. Results:Women with early-onset gestational diabetes mellitus (n = 65) were likely to be hypertensive (18.46% vs 5.88%; P = .006) and had higher glycemic values and need for insulin therapy (33.85% vs 7.06%, P = .0000) than those in whom diabetes developed later (n = 170). All the cases of neonatal hypoglycemia (n = 4) and all perinatal deaths (n = 3) were within this group (P = .005 and P = .01, respectively). Conclusions: Women with an early diagnosis of gestational diabetes represent a high-risk subgroup. (Am J Obstet Gynecol 2000;182:346-50.)