Journal of perinatal medicine · 2026
Multidimensional compliance and outcomes in gestational diabetes.
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Zhang Weili, Gong Qingqing, Zhu Yan
Аннотация
OBJECTIVES: To investigate the association between a composite multidimensional compliance score and glycemic control, maternal complications, and neonatal outcomes in women with gestational diabetes mellitus (GDM), and to evaluate these associations after adjusting for potential confounders.
METHODS: This retrospective cohort study included 360 women with GDM, diagnosed between October 2023 and January 2026 at Guiyang Second People's Hospital. A weighted compliance score (1-3) was calculated based on blood glucose monitoring, diet, physical activity, prenatal visits, and medication adherence. Participants were grouped by compliance: high, moderate, and low. Multivariate logistic regression adjusted for age, BMI, insulin use, and mobile health app use, with multiple comparisons corrected using the Benjamini-Hochberg method.
RESULTS: Most baseline demographic and clinical characteristics were comparable across compliance groups, though insulin therapy use,and mobile health application utilization differed significantly. Glycemic target achievement differed markedly: 76.23 % in the high-compliance group vs. 22.46 % in moderate and 2.00 % in low compliance. Third-trimester HbA1c was significantly lower in the high-compliance group (5.45 % ± 0.30 %) compared with moderate (5.75 % ± 0.34 %) and low (6.04 % ± 0.46 %) group. In multivariate logistic regression, low compliance was independently associated with increased odds of macrosomia, large-for-gestational-age, preterm birth, and neonatal intensive care unit admission compared with high compliance (all p<0.01). Gestational weight gain was inversely associated with compliance level.
CONCLUSIONS: Higher compliance with multiple GDM management strategies was associated with better blood sugar control and fewer maternal and neonatal complications, highlighting the value of comprehensive, integrated care.
METHODS: This retrospective cohort study included 360 women with GDM, diagnosed between October 2023 and January 2026 at Guiyang Second People's Hospital. A weighted compliance score (1-3) was calculated based on blood glucose monitoring, diet, physical activity, prenatal visits, and medication adherence. Participants were grouped by compliance: high, moderate, and low. Multivariate logistic regression adjusted for age, BMI, insulin use, and mobile health app use, with multiple comparisons corrected using the Benjamini-Hochberg method.
RESULTS: Most baseline demographic and clinical characteristics were comparable across compliance groups, though insulin therapy use,and mobile health application utilization differed significantly. Glycemic target achievement differed markedly: 76.23 % in the high-compliance group vs. 22.46 % in moderate and 2.00 % in low compliance. Third-trimester HbA1c was significantly lower in the high-compliance group (5.45 % ± 0.30 %) compared with moderate (5.75 % ± 0.34 %) and low (6.04 % ± 0.46 %) group. In multivariate logistic regression, low compliance was independently associated with increased odds of macrosomia, large-for-gestational-age, preterm birth, and neonatal intensive care unit admission compared with high compliance (all p<0.01). Gestational weight gain was inversely associated with compliance level.
CONCLUSIONS: Higher compliance with multiple GDM management strategies was associated with better blood sugar control and fewer maternal and neonatal complications, highlighting the value of comprehensive, integrated care.