Strengthening gestational diabetes mellitus prevention, diagnosis, and care in Africa: evidence and policy priorities from a systematic review, meta-analysis, and bibliometric analysis.

Gestational diabetes mellitus (GDM) is an increasing public health challenge in Africa, contributing substantially to maternal and neonatal morbidity. Evidence from our systematic review, meta-analysis, and bibliometric analysis shows that inconsistent screening practices, reliance on selective rather than universal testing, and limited health system capacity contribute to underdiagnosis and poor pregnancy outcomes. GDM is associated with adverse maternal and neonatal complications and increases the long-term risk of type-2 diabetes for mothers and offspring. Our bibliometric findings reveal uneven research capacity, limited regional collaboration, and evidence gaps across Africa. We propose five policy priorities: standardising GDM screening, strengthening prevention, expanding access to diagnostics and treatment, improving workforce capacity and follow-up, and increasing investment in African-led research to improve maternal health and reduce the intergenerational burden of diabetes.