# Gestational diabetes

Condition · id `maternal:gestational-diabetes` · Maternal & Newborn Atlas · release `fc5a600ec7387e71` (public)

> General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here.

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Browse, life stage: Pregnancy; Postpartum  
Browse, care area: Pregnancy conditions  

## In plain language

Gestational diabetes is diabetes that first appears during pregnancy, usually around the 24th week. It often has no symptoms, so pregnant people are usually tested. It usually goes away after the baby is born, but it raises the chance of developing type 2 diabetes later. It is linked with more risk of pre-eclampsia in the mother and, in the baby, with being larger than average, which can cause shoulder dystocia and birth injury, and with low blood sugar after birth.

## Technical summary

This page is the hub for screening, diagnosis criteria and treatment trials in this atlas. The US Preventive Services Task Force (2021) estimates US prevalence at 5.8% to 9.2% by traditional diagnostic criteria, possibly higher by more inclusive criteria. Which women are labelled with gestational diabetes depends on the diagnostic approach (see the bottleneck page). HAPO relates maternal glucose to outcomes across the range.

## Claims, with the population each applies to

## Context: Infants born to HAPO women with blinded 75-g glucose tolerance test data

Recipient: Newborn; Population: Infants born to women in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. 25,505 pregnant women at 15 centers in nine countries underwent 75-g oral glucose-tolerance testing at 24 to 32 weeks of gestation; 23,316 participants with blinded data were analysed. The outcomes in this context are counted in the baby: birth weight above the 90th percentile, cord-blood C-peptide above the 90th percentile and neonatal hypoglycemia.; Care setting: 15 centers in nine countries; the abstract does not describe the settings or name the countries.; Geography: Not stated in the PubMed abstract; Life stage: Pregnancy (testing at 24 to 32 weeks) and birth; Gestational age: at least 24 weeks 0 days (168 days), measured at the time of measurement; Postnatal age: Not reported; Follow-up: From the 24 to 32 week test to delivery

### In the HAPO study, 25,505 pregnant women at 15 centers in nine countries had a 75-g oral glucose-tolerance test at 24 to 32 weeks of gestation. For the 23,316 participants with blinded data, an increase of 1 standard deviation in the fasting (6.9 mg per deciliter), 1-hour (30.9 mg per deciliter) and 2-hour (23.5 mg per deciliter) plasma glucose was associated, in that order, with adjusted odds ratios for a birth weight above the 90th percentile of 1.38 (95% CI 1.32 to 1.44), 1.46 (1.39 to 1.53) and 1.38 (1.32 to 1.44); for cord-blood C-peptide above the 90th percentile, 1.55 (1.47 to 1.64), 1.46 (1.38 to 1.54) and 1.37 (1.30 to 1.44); and for neonatal hypoglycemia, 1.08 (0.98 to 1.19), 1.13 (1.03 to 1.26) and 1.10 (1.00 to 1.12). The abstract reports no obvious thresholds at which risks increased, and associations with secondary outcomes tended to be weaker.

- Category: Description
- Evidence stage: Observational
- Certainty: Certainty not assessed
- Applies to: Recipient: Newborn; Population: Infants born to women in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. 25,505 pregnant women at 15 centers in nine countries underwent 75-g oral glucose-tolerance testing at 24 to 32 weeks of gestation; 23,316 participants with blinded data were analysed. The outcomes in this context are counted in the baby: birth weight above the 90th percentile, cord-blood C-peptide above the 90th percentile and neonatal hypoglycemia.; Care setting: 15 centers in nine countries; the abstract does not describe the settings or name the countries.; Geography: Not stated in the PubMed abstract; Life stage: Pregnancy (testing at 24 to 32 weeks) and birth; Gestational age: at least 24 weeks 0 days (168 days), measured at the time of measurement; Postnatal age: Not reported; Follow-up: From the 24 to 32 week test to delivery
- Limitations: An observational study, so these are associations. Data stayed blinded only if the fasting glucose was 105 mg per deciliter or less and the 2-hour glucose was 200 mg per deciliter or less, so the analysis covers women below those limits. The last interval for neonatal hypoglycemia (1.00 to 1.12) is reported as the PubMed abstract prints it; the full text was not read to check it. Maternal outcomes are in a separate claim. The abstract does not name the 15 centers or the nine countries. Only the PubMed abstract was read.
- Last checked: 2026-10-14
- Sources:
  1. Supports: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, RESULTS, sentence 2. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: PubMed abstract of the HAPO report (NEJM 2008).
  2. Supports: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, RESULTS, sentence 3. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: PubMed abstract of the HAPO report (NEJM 2008).
  3. Supports: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, RESULTS, sentence 4. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: PubMed abstract of the HAPO report (NEJM 2008).
  4. Supports: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, CONCLUSIONS, sentence 1. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: PubMed abstract of the HAPO report (NEJM 2008).
  5. Background: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, METHODS, sentence 1. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: Design, methods and the blinded analysis set.
  6. Background: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, METHODS, sentence 2. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: Design, methods and the blinded analysis set.
  7. Background: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, METHODS, sentence 3. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: Design, methods and the blinded analysis set.
  8. Background: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, RESULTS, sentence 1. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: Design, methods and the blinded analysis set.

## Context: HAPO women with blinded 75-g glucose tolerance test data

Recipient: Maternal; Population: Pregnant women in the HAPO study who had 75-g oral glucose-tolerance testing at 24 to 32 weeks of gestation, 23,316 of whom had blinded data. The outcome in this context is primary cesarean delivery.; Care setting: 15 centers in nine countries; the abstract does not describe the settings or name the countries.; Geography: Not stated in the PubMed abstract; Life stage: Pregnancy (testing at 24 to 32 weeks) and delivery; Gestational age: at least 24 weeks 0 days (168 days), measured at the time of measurement; Postnatal age: Not reported; Follow-up: From the 24 to 32 week test to delivery

### In the HAPO study, among 23,316 participants with blinded data, an increase of 1 standard deviation in the fasting, 1-hour and 2-hour plasma glucose at a 75-g oral glucose-tolerance test (24 to 32 weeks of gestation) was associated, in that order, with adjusted odds ratios for primary cesarean delivery of 1.11 (95% CI 1.06 to 1.15), 1.10 (1.06 to 1.15) and 1.08 (1.03 to 1.12).

- Category: Description
- Evidence stage: Observational
- Certainty: Certainty not assessed
- Applies to: Recipient: Maternal; Population: Pregnant women in the HAPO study who had 75-g oral glucose-tolerance testing at 24 to 32 weeks of gestation, 23,316 of whom had blinded data. The outcome in this context is primary cesarean delivery.; Care setting: 15 centers in nine countries; the abstract does not describe the settings or name the countries.; Geography: Not stated in the PubMed abstract; Life stage: Pregnancy (testing at 24 to 32 weeks) and delivery; Gestational age: at least 24 weeks 0 days (168 days), measured at the time of measurement; Postnatal age: Not reported; Follow-up: From the 24 to 32 week test to delivery
- Limitations: An observational study, so these are associations. Data stayed blinded only if the fasting glucose was 105 mg per deciliter or less and the 2-hour glucose was 200 mg per deciliter or less. The abstract names primary cesarean delivery as one of four primary outcomes; the newborn outcomes are in a separate claim. Only the PubMed abstract was read.
- Last checked: 2026-10-14
- Sources:
  1. Supports: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, RESULTS, sentence 2. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: PubMed abstract of the HAPO report (NEJM 2008).
  2. Background: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, METHODS, sentence 1. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: Design, methods and the blinded analysis set.
  3. Background: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, METHODS, sentence 2. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: Design, methods and the blinded analysis set.
  4. Background: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, METHODS, sentence 3. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: Design, methods and the blinded analysis set.
  5. Background: Hyperglycemia and adverse pregnancy outcomes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa0707943>
     Locator: Abstract, RESULTS, sentence 1. Retrieved 2026-10-14T18:18:23Z. Source state: Current. Snapshot hash: df9ac5395730e8be76f56156340144b92a85d82ac39a1cd6d4c2f0679a85455c.
     How it applies: Design, methods and the blinded analysis set.

## Context: Pregnant persons not previously diagnosed with type 1 or type 2 diabetes (USPSTF 2021)

Recipient: Maternal; Population: Pregnant persons who have not been previously diagnosed with type 1 or type 2 diabetes.; Care setting: Not stated in the PubMed abstract; Geography: United States (statement of the US Preventive Services Task Force); the abstract names no country.; Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context)

### The USPSTF reports that the prevalence of gestational diabetes in the United States has been estimated at 5.8% to 9.2% based on traditional diagnostic criteria, although it may be higher if more inclusive criteria are used. It lists preeclampsia among the complications for which pregnant persons with gestational diabetes are at increased risk.

- Category: Burden
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Maternal; Population: Pregnant persons who have not been previously diagnosed with type 1 or type 2 diabetes.; Care setting: Not stated in the PubMed abstract; Geography: United States (statement of the US Preventive Services Task Force); the abstract names no country.; Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context)
- Limitations: This is a background statement in the abstract, not a new analysis, and the abstract does not give the source of the prevalence estimate. The criteria that label a woman as having gestational diabetes differ between approaches (see the page on glucose tests). Fetal and newborn complications that the same abstract lists are not part of this maternal claim. Only the PubMed abstract was read. PubMed links a published erratum (PMID 34609473, Incorrect Value in Table); its correction text was not read, so whether it changes this claim is not known.
- Last checked: 2026-10-14
- Source problem: a cited source is corrected. Check the sources before relying on this claim.
- Sources:
  1. Supports: Screening for Gestational Diabetes: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. PubMed links a published erratum (PMID 34609473, titled Incorrect Value in Table); its text has no abstract and was not read, so the statement is cited as the PubMed abstract gives it.) <https://doi.org/10.1001/jama.2021.11922>
     Locator: Abstract, IMPORTANCE, sentence 2. Retrieved 2026-10-14T18:18:21Z. Source state: Corrected. Snapshot hash: 178631f5dca566eb6af7f1a40ccd4d56431ea24170c6ef78b2942f5e4efccd97.
     How it applies: PubMed abstract of the USPSTF 2021 statement, background section.
  2. Supports: Screening for Gestational Diabetes: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched. PubMed links a published erratum (PMID 34609473, titled Incorrect Value in Table); its text has no abstract and was not read, so the statement is cited as the PubMed abstract gives it.) <https://doi.org/10.1001/jama.2021.11922>
     Locator: Abstract, IMPORTANCE, sentence 3. Retrieved 2026-10-14T18:18:21Z. Source state: Corrected. Snapshot hash: 178631f5dca566eb6af7f1a40ccd4d56431ea24170c6ef78b2942f5e4efccd97.
     How it applies: PubMed abstract of the USPSTF 2021 statement, background section.

## Connected pages

- The wider condition, diabetes mellitus: Diabetes mellitus (`core:diabetes-mellitus`)
- Filed under this front: Screening and tests (`maternal:front-screening-and-tests`)
- Both are pregnancy conditions with later cardiometabolic risk (existing record): Hypertensive disorders of pregnancy (`maternal:hypertensive-disorders-of-pregnancy`)
- Related to: Low blood sugar in newborns (neonatal hypoglycaemia) (`maternal:neonatal-hypoglycaemia`)
- Recommended for this: Glucose tests for gestational diabetes (one-step and two-step) (`maternal:gdm-glucose-screening-test`) [a claim, not a settled fact; see claim `maternal:claim-uspstf-2021-gdm-screening-24-weeks-or-after` and its context]
- Treated by: Treatment of gestational diabetes (diet, glucose monitoring, insulin or metformin) (`maternal:gdm-treatment`) [a claim, not a settled fact; see claim `maternal:claim-achois-serious-perinatal-complications` and its context]
- Evaluated for this: Treatment of gestational diabetes (diet, glucose monitoring, insulin or metformin) (`maternal:gdm-treatment`) [a claim, not a settled fact; see claim `maternal:claim-mfmu-primary-neonatal-composite` and its context]
- Evaluated for this: Treatment of gestational diabetes (diet, glucose monitoring, insulin or metformin) (`maternal:gdm-treatment`) [a claim, not a settled fact; see claim `maternal:claim-mig-metformin-versus-insulin-neonatal-composite` and its context]
- Related to: Diabetes testing after gestational diabetes (`maternal:postpartum-diabetes-screening-after-gdm`)
- Investigated in: HAPO study (Hyperglycemia and Adverse Pregnancy Outcome) (`maternal:hapo-study`)
- Investigated in: MFMU trial of treatment for mild gestational diabetes (`maternal:mfmu-mild-gdm-trial`)

## Provenance

Content hash: 39423118504803a0e97a0e0bfeebc01cd47141937908251e8f184d94dd13d7f8
Last substantive edit: 2026-10-14
Evidence last checked: 2026-10-14