Impact of Structured Primary Care Follow-Up on Maternal and Neonatal Outcomes Among Women with Gestational Diabetes Mellitus in Saudi Arabia: A Retrospective Cohort Study
DOI:
https://doi.org/10.69980/ajpr.v28i5.594Keywords:
Gestational diabetes mellitus, postpartum care, primary care follow-up, maternal outcomes, neonatal complications, Saudi Arabia, macrosomia, preeclampsia, HbA1c, NICU admissionAbstract
Background: Gestational diabetes mellitus (GDM) is associated with increased maternal and neonatal morbidity. Postpartum follow-up is critical for glycemic control and prevention of complications, yet many women fail to receive structured care.
Objective: To assess the impact of structured primary care follow-up on maternal and neonatal outcomes among Saudi women diagnosed with GDM.
Methods: A retrospective cohort study was conducted at three primary healthcare centers and affiliated tertiary hospitals in Riyadh and Al-Baha. Women aged 18–45 with singleton pregnancies and GDM (diagnosed 2021–2024) were stratified into structured (≥4 visits) and unstructured (<2 visits) follow-up groups. Data were extracted from electronic records. Outcomes included preeclampsia, cesarean delivery, neonatal hypoglycemia, macrosomia, NICU admission, and HbA1c levels. Chi-square and t-tests assessed group differences. Logistic regression identified adjusted predictors (p < 0.05).
Results: Among 300 women (150/group), the structured group had lower rates of preeclampsia (8.7% vs. 17.3%, p = 0.02), cesarean delivery (33.3% vs. 46.7%, p = 0.01), neonatal hypoglycemia (10.0% vs. 20.7%, p = 0.005), and macrosomia (6.0% vs. 13.3%, p = 0.01). NICU admission was also reduced (13.3% vs. 22.0%, p = 0.04). Third-trimester HbA1c was significantly lower in the structured group (5.9% vs. 6.3%, p = 0.01).
Conclusion: Structured primary care follow-up is associated with improved maternal and neonatal outcomes among women with GDM. Integrating standardized follow-up pathways in primary care settings may enhance clinical outcomes and long-term glycemic control in this population.
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